area plan, july 1, 2016-june 30, 2020 - stanislaus county · area plan, july 1, 2016-june 30, 2020....
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STANISLAUS COUNTY
Area Agency on Aging
Area Plan, July 1, 2016-June 30, 2020
Margie Palomino, Director
The Area Plan for the Stanislaus County Area Agency on Aging outlines the way that the funds from the Older Americans Act will be used to provide services for senior citizens, caregivers of frail elders, and persons with disabilities.
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Table of Contents Stanislaus County Area Agency on Aging
Area Plan 2016-2020
1. Checklist …………………………………………………………………………………....Pg. 2
2. Transmittal Letter ………………………………………………………………………….. 3
3. Introduction ……………………………………………………………………………..…. 4
4. Section 1-Mission Statement ……….…………………………………………………....... 6
5. Section 2-Description of the Planning and Service Area (PSA) ………………………….. 6
6. Section 3-Description of the Area Agency on Agency …………………………………… 15
7. Section 4-Planning Process/Establishing Priorities……………................................. …… 19
8. Section 5-Needs Assessment ……………………………………………………………… 21
9. Section 6-Targeting ……………………………………………………………………….. 29
10. Section 7-Public Hearings ………………………………………………………………… 34
11. Section 8-Identification of Priorities ...……………………………………………………. 38
12. Section 9-Narrative Goals and Objectives ………………………………………………... 41
13. Section 10-Service Unit Plan Objectives …………………………………………………. 48
14. Section 11-Focal Points …………………………………………………………………… 73
15. Section 12-Disaster Preparedness ………………………………………………………….. 74
16. Section 13-Priority Services ………………………………………………………………. 77
17. Section 14-Notice of Intent to Provide Direct Services ………………………………….. 79
18. Section 15-Request for Approval to Provide Direct Services, HICAP …………………… 82
19. Section 15-Request for Approval to Provide Direct Services, Cash/Material Aid ………. 84
20. Section 15-Request for Approval to Provide Direct Services-FCSP-Respite …………… 86
21. Section 15-Request for Approval to Provide Direct Services-FCSP-Supplemental Services 88
22. Section 16-Governing Board …………………………………………………………….. 90
23. Section 17-Advisory Council …………………………………………………………….. 91
24. Section 18-Legal Assistance ……………………………………………………………… 94
25. Section 19-Multipurpose Senior Center ………………………………………………….. 98
26. Section 20-Family Caregiver Support Program …………………………………………. 99
27. Section 21-Organization Chart …………………………………………………………… 103
28. Section 22-Assurances ……………………………………………................................... 104
PSA 30
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2016-2020 4-YEAR AREA PLAN REQUIRED COMPONENTS CHECKLIST To ensure all required components are included, “X” mark the far-right column boxes.
Enclose a copy of the checklist with your Area Plan; submit this form with the Area Plan due 5/1/16 only
Section Four-Year Area Plan Components 4-Year Plan
Transmittal Letter – must have original, ink signatures or official signature stamps- no photocopies
1 Mission Statement X 2 Description of the Planning and Service Area (PSA) X 3 Description of the Area Agency on Aging (AAA) X 4 Planning Process / Establishing Priorities X 5 Needs Assessment X 6 Targeting X 7 Public Hearings X 8 Identification of Priorities X 9 Area Plan Narrative Goals and Objectives: 9 Title IIIB Funded Program Development (PD) Objectives X 9 Title IIIB Funded Coordination (C) Objectives X 9 System-Building and Administrative Goals & Objectives X 9 Title IIIB/VII A Long-Term Care Ombudsman Objectives X 9 Title VII Elder Abuse Prevention Objectives X
10 Service Unit Plan (SUP) Objectives and Long-Term Care Ombudsman Outcomes X
11 Focal Points X 12 Disaster Preparedness X 13 Priority Services X 14 Notice of Intent to Provide Direct Services X 15 Request for Approval to Provide Direct Services X 16 Governing Board X 17 Advisory Council X 18 Legal Assistance X 19 Multipurpose Senior Center Acquisition or Construction Compliance Review X 20 Title III E Family Caregiver Support Program X 21 Organization Chart X 22 Assurances X
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TRANSMITTAL LETTER
2016-2020 Four Year Area Plan/ Annual Update Check one: X FY 16-20 ☐ FY 17-18 ☐ FY 18-19 ☐ FY 19-20
AAA Name: Stanislaus County Area Agency on Aging PSA 30
This Area Plan is hereby submitted to the California Department of Aging for approval. The
Governing Board and the Advisory Council have each had the opportunity to participate in the
planning process and to review and comment on the Area Plan. The Governing Board,
Advisory Council, and Area Agency Director actively support the planning and development of
community-based systems of care and will ensure compliance with the assurances set forth in
this Area Plan. The undersigned recognize the responsibility within each community to
establish systems in order to address the care needs of older individuals and their family
caregivers in this planning and service area.
Original Transmittal Letter with signatures was sent via regular mail.
1.Dick Monteith (Type Name) ____________________________ _______________ Signature: Board of Supervisors Chair 1 Date 2. Jeri Johnson (Type Name) _____________________________ ________________ Signature: Commission on Aging President Date 3. Margie Palomino (Type Name) _____________________________ ________________
Signature: Aging and Veterans Services Director Date
1 Original signatures or official signature stamps are required.
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Stanislaus County Area Agency on Aging Area Plan, 2016-2020
Introduction
The Stanislaus County Area Agency on Aging is known to the California Department of Aging
as the designated Planning and Service Area (PSA 30) for the County. The Area Agency on Aging
receives funding from the Older Americans Act to provide services to assist persons over the age of 60,
caregivers of frail elders, and persons with disabilities. The staff at the Agency is required to write the
Area Plan that outlines for all citizens the ways the Area Agency on Aging (AAA) staff anticipates
providing those services for the next four years.
In a recent survey five areas of concern were highlighted by respondents: daily life activities,
isolation, financial concerns, accessing services and caring for others. AAA staff met with various
groups to determine needs that were not articulated through the survey. Information from other
community surveys was used in addition to the AAA survey and meetings to inform the staff of the
needs and resources of seniors in the County.
The Plan includes descriptions of Stanislaus County and the Area Agency on Aging. Also
included are detailed results of the survey and other assessments of the needs of consumers. Information
is included that states how the AAA staff will attempt to meet the needs of the potential consumers. A
portion of this report includes estimates of the number of consumers that will be served by a variety of
services. The Plan concludes with added information about specific services that the AAA staff will
accomplish directly, and requisite assurances of the type and extent of services made available to the
seniors in Stanislaus County.
A major need expressed by staff members at provider agencies and members of the general
public was for agencies to work together more effectively, making it possible for seniors to live
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independently and safely in their homes. Information is included that illustrates how the AAA staff
anticipates continuing existing partnerships and developing new ones.
Information about various services and current providers is available at the Stanislaus County
web site, www.StanCounty.com, with a link to the Aging and Veterans Services Department, or
www.agingservices.info. All of the services that are funded by the Older Americans Act through the
AAA are available without cost. The services are available for any person over the age of 60, caregivers
of frail elders, and persons with disabilities, without regard to income. Details about any of the services
are available by contacting the AAA office, 209-558-8698 or 1-800-510-2020.
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STANISLAUS COUNTY AREA AGENCY ON AGING
SECTION 1. Mission Statement:
The reasons for the Stanislaus County Area Agency on Aging to exist and the purpose in the community are: ♦ To provide leadership in addressing issues that relate to older Californians, particularly to persons in Stanislaus County. ♦ To develop community-based systems of care that provide services which support independence within California’s interdependent society, and which protect the quality of life of older persons and persons with functional impairments. ♦ To promote citizen involvement in the planning and delivery of services to older persons and persons with functional impairments. SECTION 2. Description of the Planning and Service Area (PSA):
Stanislaus County is located in the Central Valley, midway between San Francisco and the Sierra
Nevada mountains. It is a mix of rural, suburban and urban areas, bisected by State Route 99 and
Interstate 5. There are nine incorporated cities, most of which are relatively small. Modesto is the
largest city, geographically and with the highest population- approximately 210,000 persons. The
California Department of Finance Demographic Resource Unit has estimated that the County will be
home to 545,188 persons in 2016. Of those, approximately 97,100, or 17.8% of the population, will be
over the age of 60. Approximately 20,860 seniors live in poverty, qualifying for Medi-Cal2. This
number does not include seniors whose income is relatively low, but above the threshold to qualify for
various assistance programs.
Approximately 32,880 seniors consider themselves to be a part of a minority group. Within that
group, 7,230 seniors can be considered to have income that is low, based upon the estimate of the
number of seniors who qualify for Medi-Cal and the percentage of seniors that identify as part of a
minority population. The highest concentration of persons, 65+, whose income is below the FPL, is in
the southeast corner of Modesto and a portion of the county that is rural, east of Modesto3. For the
2 http://www.aging.ca.gov/docs/DataAndStatistics/Statistics/IFF/2016_Population_Demographic_Projections.pdf
3 US Census American Community Survey (ACS) Table S1701; 2007-2011 combined.
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senior population, approximately 5%, or 4,930, do not speak English. The largest minority group
designate themselves to be ethnically Hispanic, 22.9% of seniors, approximately 22,200 seniors. The
next largest minority group of seniors identify as Asian at 5.3% , then African American, 2.3%,
American Indian, 0.9%, Native Hawaiian/Alaskan Native, 0.6%, and two or more ethnicities, 1.86%4.
As part of California’s Central Valley, a major industry in Stanislaus County is agriculture, and
corporations associated with agriculture. Products that come from Stanislaus County include almonds,
walnuts, peaches, apricots, dairy products, olives, wine grapes, melons, poultry products and tomatoes.
The Gallo Winery is based in Modesto, as is Stanislaus Foods, processor of tomatoes for pasta and pizza
sauces. Frito-Lay and Del Monte have plants in Modesto, and Con Agra Foods is located in Oakdale.
Companies that are known regionally include Sciabica Olive Oil and Sconza Candy Company. Outside
of the cities and suburbs is range land for cattle and orchards.
Higher education opportunities are available in Stanislaus County. The Modesto Junior College
(MJC) provides Associates Degrees as well as technical degrees. MJC has classes to assist persons
attain their GED. The College provides numerous classes to enhance various aspects of modern life for
all ages, and provides space for the Modesto Institute for Continued Learning (MICL). The programs
available through MJC appeal to retirees, keeping many seniors active and enjoying a good quality of
life. These include bus trips, seminars with nationally known scholars as speakers, and personal
improvement classes.
Turlock is home to the California State University, Stanislaus. CSU, Stanislaus has over 9,000
students enrolled in both undergraduate and graduate majors. Students can choose from 189 major
fields of study, including 35 masters level majors, two doctoral majors, and 14 teaching credential
majors. Other institutions located in Modesto are: California Beauty College, Humphrey’s College,
4 http://www.dof.ca.gov/research/demographic/reports/projections/P-3/.
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Computer Tutor Business and Technical Institute, Kaplan College, San Joaquin Valley College, and the
Community Business College.
The Area Agency on Aging (AAA) is half of the Stanislaus County Department of Aging and
Veterans Services. The Veterans Representatives assist veterans and their dependents, regardless of
their age, and regularly refer older veterans to services through the AAA. In addition to the day-to-day
operations in the Department, the AAA staff has been active in establishing specific services for older
veterans. A member of the Commission on Aging advisory council is the Program Manager of MOVE,
a division of Paratransit, a Consolidated Transportation Services Agency. The staff of MOVE assists
seniors and persons with disabilities to understand the fixed route bus systems; coordinates a volunteer
driver program known as Bridges; and coordinates rides for homebound veterans, to get to the Veterans
Clinic in Modesto and to the San Francisco Bay Area medical facilities in Livermore and Palo Alto.
The AAA staff continues to have contracts with non-profit agencies for many of the Older
Americans Act (OAA) services. Congregate meals and home-delivered meals are currently under
contract to the Howard Training Center. This agency serves the needs of persons with disabilities,
including work experience programs in the food services. With specifically trained supervisors, and
according to the guidelines of the OAA food programs, some of the Howard Training Center
participants assist in the preparation of the congregate meals. Senior meals are available at 13 sites
throughout the county, in rural as well as urban settings. Home-delivered meals are individually frozen,
and are delivered twice a week to homebound seniors throughout the county. The seniors receive a total
of five meals each week. The meals can be heated in regular or microwave ovens, and are accompanied
by individual cartons of milk, bread that is appropriate to the menu and fresh fruit, according to the
season. During fiscal year 2014-2015, 1,027 seniors enrolled in the home-delivered meals program and
received 139,245 meals. In the congregate meals program, 880 seniors enrolled in fiscal year 2015-
2015, and received 56,205 meals at sites throughout the county.
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The Homemaker Program is coordinated through the local division of Catholic Charities.
Trained homemakers provide light housekeeping to frail, mostly solitary seniors, twice per month.
Several of the homemakers have been employed by Catholic Charities for many years, assisting the
same seniors. It continues to be one of the programs that directly enhance the lives of these seniors,
helping them maintain their independence.
Other services contracted to Catholic Charities are the Long Term Care Ombudsman Program
and the Elder Abuse Prevention Program. For the nearly 100 care facilities in Stanislaus County, 20
trained and certified Ombudsmen have successfully handled issues that have concerned frail seniors in
long term care facilities. The staff at Catholic Charities has sponsored new training classes at least
annually for new potential ombudsmen, and requires monthly training of their current volunteers to
maintain their certification. The Stanislaus Elder Abuse Prevention Alliance (SEAPA) is a group of
staff and volunteers from Catholic Charities, the AAA, law enforcement, Adult Protective Services, care
facilities, the Commission on Aging, clergy, and municipal offices in various communities. The
members of SEAPA meet to plan events to assist seniors and their caregivers to understand current ways
that elders may be in danger of abuse, and how to prevent becoming victims of elder abuse. Various
members have been active in advocating for government protections for seniors.
The staff of the Healthy Aging Association continues to train seniors to assist other seniors to
maintain their physical health with exercises specifically designed to strengthen muscles and prevent
debilitating falls. The Young At Heart classes provide socialization opportunities as well as the
exercises. Though the program has not achieved the level of being certified as “evidence-based” for the
use of OAA funds, the classes will continue for the over 1,200 regular participants. The staff of the
Healthy Aging Association has received grant funds to coordinate a SNAP-Ed program, providing
classes in nutrition and exercise titled “Eat Better, Move Better”. These classes have been held at most
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of the Young at Heart exercise classes, and have successfully provided nutrition information to over 150
low income participants since mid-2014.
For the last seven years, the staff of the Healthy Aging Association has offered the “A Matter of
Balance” classes throughout the county. Currently there are 35 seniors enrolled in 4 class sites, with
training for new volunteer instructors occurring in early 2016. As this program has been certified to be
evidence-based (according to the requirements from the U.S. Department of Health and Human
Services), the Healthy Aging Association will continue to be the recipient of OAA funds, dedicated to
the A Matter of Balance program. In addition to the programs listed above, a class of 30 participants has
been practicing Tai Chi twice per week for a number of years. This program is evidence-based and will
be part of the OAA grant to the Healthy Aging Association.
For the last 13 years the AAA and the Healthy Aging Association have co-sponsored the annual
Healthy Aging and Fall Prevention Summit, held in October. The Summit provides free health
screenings to anyone over the age of 55, including balance testing, cholesterol and blood pressure
checks, diabetes, hearing and visual tests, bone density and depression screening. Flu and pneumonia
shots are a regular feature. In addition, over 70 vendors provide free information about a variety of
health-related services. Featured speakers have given seminars on depression and living with diabetes.
Popular features have been demonstrations of exercise classes, container gardening in small spaces, and
various door prize opportunities. For the past several years the Second Harvest Food Bank has
distributed fresh fruits and vegetables to participants as a reward for showing proof they visited all of the
information booths. Over 1,200 seniors and caregivers have participated. The next Summit will be
October 21, 2016.
The OAA Section Title V Senior Community Service Employment Program is currently
contracted to SER-Jobs for Progress. The program is small, currently 12 participants, with 35 on the
waiting list. The seniors are learning ways to improve their skills and various local non-profit agencies
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have benefitted from helping to train the seniors for new jobs. In Stanislaus County the unemployment
rate was 9.4% in February 2016, down from 11% in 2015. That figure is higher than the state and
national average, making it challenging for seniors to find work in Stanislaus County, when competing
with younger persons.
The Senior Law Project has been contracted to the Senior Advocacy Network for over five years.
The staff and volunteers continue to assist seniors with legal questions, issues, restraining orders and
advocacy. During last fiscal year (July 2014-June 2015), the staff of the Senior Law Project assisted
over 1,000 seniors. They maintain professional relationships with the Adult Protective Services
department and the contractor for the Long Term Care Ombudsman Program. They have been leaders in
attempting to raise awareness about the multiple telephone and internet scams that continue to occur in
our area, participating in elder abuse prevention forums and establishing the Stanislaus SCAM Line,
209-996-SCAM (7226). The SCAM line is available 24 hours a day to inform the public about recent
scams, encouraging the caller to contact the staff of the Senior Advocacy Network for further
information. The Senior Advocacy Network staff designed and printed free door knob hangers that list
the top ten scams, with descriptions, and the SCAM Line number.
The AAA provides a number of OAA services directly. These include Information and
Assistance (I&A), Outreach, Case Management, and the Family Caregiver Support Program. The Health
Insurance Counseling and Advocacy Program (HICAP) is also provided as a direct service at the AAA.
The I&A staff continue to be the main resource for senior services in the County, the services
that are funded by the OAA and many other services available through other agencies. Though the
AAA needs to find more ways to provide information, there are numerous agencies that consistently
invite the staff to participate in outreach events.
The most recent direct service available through the AAA is Case Management. A social worker
was hired in 2015 to assist seniors that don’t qualify for the Multipurpose Senior Services Program
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(MSSP). The staff works with seniors who need help navigating to programs that will make it possible
for them to remain independent. This can be as little as helping them access the meals programs and
complete forms for utility assistance, or as much as working with Adult Protective Services to help them
re-locate or protect them from persons who may be abusing them.
The AAA has provided the Family Caregiver program for the last 13 years, funding short term
respite for informal caregivers and purchasing assistive devices that aid the caregiver. The contracts
with home health agencies have given caregivers the extra assistance needed to ensure they are able to
continue their important work of caring for their loved one. As a direct service, the AAA staff has been
able to provide help while keeping basic costs at a minimum, leaving more funding available for the
much-needed services.
The staff and volunteers for the HICAP program are integral members of the staff at the AAA,
with I&A staff assisting with receptionist duties. Since the office areas are shared with other AAA
programs, overhead costs are kept relatively low, allowing the HICAP manager, staff and volunteers the
opportunity to concentrate on interpreting Medicare for the seniors of Stanislaus County.
A small, but important, program accomplished directly by the AAA staff is the OAA program,
Cash/Material Aid. This program has been used to assist seniors who need one-time assistance to pay
overdue utility or rent bills; purchase necessary appliances; or other assistance not available from other
programs. The AAA staff carefully evaluates each case, ensuring that the funds are reserved for seniors
that have no other means to handle the specific needs, making it possible for them to remain in their
homes as long as is safe and practical.
For the past five years the AAA office has included the staff from the Multipurpose Senior
Services Program (MSSP). This program receives funds from the State to assist frail seniors, over 65
and on Medi-Cal with no share of cost, to remain in their homes instead of moving to skilled nursing
facilities. Many of the Older Americans Act services dovetail well with the case management available
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through MSSP, and the staffs of the other AAA programs have been available to assist potential MSSP
clients. Referrals between the programs occur smoothly and provide extra benefits for the seniors and
their caregivers. Co-locating the MSSP program with other AAA programs has enhanced all of the
services available for seniors.
The AAA staff and Commission on Aging members have been active participants with a group
of agencies attempting to work together to provide extended care for and with seniors in the larger
community. The Senior Coalition of Stanislaus County includes staff from the AAA, the Healthy Aging
Association, the Disability Resource Agency for Independent Living (DRAIL), local hospitals,
representatives from in-home health care companies, health insurance companies, the In Home
Supportive Services Public Authority, Adult Protective Services, Catholic Charities, and the County
Behavioral Health and Recovery Services department. The Coalition was formed to work in preparation
for the planned statewide mandate for all seniors who are “dual-eligible”, seniors who receive both
Medicare and Medi-Cal health insurance, to be part of the Coordinated Care Initiative (CCI) managed
care program. The Coalition members participate in monthly calls to understand the challenges being
faced by the counties currently implementing the CCI program, and to prepare for the potential time
when Stanislaus County agencies will be included in the CCI. In addition to preparing for future
participation, the Coalition members are seeking ways to better coordinate care to assist all seniors,
regardless of their financial status. Information about available services and the means to access those
services continues to be the priority for all participants in the Coalition. Towards that end, a guide to
some of the services, titled “Caregiver Information, Services and Resources in Stanislaus County”, has
been distributed through various organizations. The guide is also available on the AAA website,
www.agingservices.info. The Coalition coordinators have recently submitted a Strategic Plan to their
funding source, the SCAN Foundation. That plan outlines the steps Coalition members intend to take in
the next few years to further assist seniors, caregivers, and persons with disabilities.
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The Stanislaus Senior Foundation was established to raise funds to meet the needs of seniors that
cannot be met from other sources. Over the past several years the AAA has coordinated with Adult
Protective Services and other community agencies to assist seniors who were facing eviction, the
disconnection of utility services, or who may need assistive devices. The AAA staff evaluates each
request and determines the best way to assist the senior, deciding between this grant and the OAA
Cash/Material Aid program, which may be the best option for each request. Funds from the Foundation
have also been used to enhance the quality of life for low income seniors by providing holiday gift
baskets, purchasing ukuleles for volunteer groups, and I-pods to be used by care facility residents with
dementia. AAA staff, members of the Commission on Aging and staff from other agencies volunteer
their time to coordinate these efforts and to plan the fund raisers that make their assistance possible.
Following the passage of Proposition 63, the Mental Health Services Act, the Stanislaus County
Behavioral Health and Recovery Services (BHRS) Department has contracted with the AAA to provide
services to assist seniors who may be depressed, or could become depressed. The Prevention and Early
Intervention (PEI) programs include one-on-one assistance for seniors in their homes. Services include
Brief Counseling, Peer Counseling, and Friendly Visitor programs. Following basic evaluation by a
social worker, a senior is given the opportunity to receive counseling by a clinician, counseling with a
peer volunteer, or to be paired with a friendly visitor volunteer. The AAA staff and volunteers involved
in each of these services aim to help seniors deal with the challenges that can come when they
experience any number of inevitable life changes. The staff and volunteers have been successful with
many seniors that have been referred to the programs. The main challenge that remains is helping some
seniors understand that they can ask for and receive help to cope with the things that happen to most
people.
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SECTION 3. Description of the Area Agency on Aging (AAA)
The Stanislaus County Aging and Veterans Services Department, Area Agency on Aging (AAA)
division has been an integral part of the community for many years. The AAA has a reputation among
service organizations as being responsive to the needs of seniors, persons with disabilities, and
caregivers. There are many agencies that call the Information and Assistance flyer their “bible” when
looking for assistance for their clients. But the AAA also suffers from apparently being the best-kept
secret for many people. Too often it is said that potential clients did not know that various services were
offered to seniors. Too often it is believed that since the AAA is a County agency, a potential client is
restricted by his or her income level. The staff attempts numerous ways to reach members of the
community that could benefit from the services, but more creative ways need to be explored.
As stated earlier, the AAA staff is active in the Senior Coalition of Stanislaus County. Staff
members from the HICAP and MSSP programs have been an integral part of the Coalition since their
clients are the “dual-eligible” seniors that will be most affected by the Coordinated Care Initiative (CCI)
mandate to ensure their participation in managed care. Staff members from these programs have
regularly participated in Coalition meetings, monthly conference calls with the SCAN Foundation staff
(the agency that provided grant funds for the Coalition), and have attended the annual conferences in
Sacramento. Other AAA staff chaired the committee to design the Caregiver Resource booklet and
continue to direct caregivers and seniors to the agencies and programs listed in it. Plans for the fall
prevention part of the Healthy Aging Summit are part of the Strategic Plan and include responsibility for
AAA staff members.
The local Metropolitan Planning Organization and Regional Transportation Planning Agency is
the Stanislaus Council of Governments (StanCOG). Information on their website states their purpose
as: “StanCOG provides the forum that brings mayors, city council members and county supervisors
together to work on regional issues in a setting that promotes the involvement of the public in the
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planning process for the Stanislaus region.”5 As seniors have continued to “age in place”, the AAA and
other senior service agencies recognized the growing need for door-through-door, door-to-door, and
other transportation services. The AAA staff, Commission on Aging members, and the staff of Catholic
Charities petitioned StanCOG to help meet these needs. The process to establish the existence of unmet
needs for transportation resulted in the dedication of some transportation dollars and the grant to
Paratransit, Inc. to fund the Consolidated Transportation Services Agency (CTSA). In October, 2015
the CTSA became MOVE. The staff of MOVE coordinates a Travel Training program and two
volunteer driver programs that assist seniors, persons with disabilities, and veterans. The AAA staff
works closely with the staff of MOVE to help seniors understand and take advantage of programs to
enhance their lives, using transportation services at a point in their lives when they are no longer able to
drive. Commission on Aging members and AAA staff have actively been involved with StanCOG,
particularly during the last year when the StanCOG staff has been doing surveys and focus groups to
determine the future transportation needs of the County. One of the Commission on Aging members is
the program manager of MOVE. She chairs one of the StanCOG committees, the Social Services
Transportation Advisory Committee. Two members of the Commission on Aging, the AAA director,
the director of the local Catholic Charities office, and a representative from the Disability Resource
Agency for Independent Living (DRAIL) are part of this committee. They all have made major
contributions to addressing the transportation services available in Stanislaus County on behalf of their
clients.
A new Public Transit-Human Services Coordination Plan will be finalized in the next few
months. A significant part of the contributions towards this plan have come from consumers through
focus groups, including many at senior and community centers. Members of the AAA and Veterans
Services staff have encouraged participation in the process through the surveys and public meetings. 5 http://www.stancog.org/
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Through contacts with other agencies, consumers have been invited to submit documentation regarding
unmet transit needs.
The AAA has been part of the Department of Aging and Veterans Services for almost 20 years.
As such the AAA staff works closely with the Veterans Services Officers to assure veterans and their
dependents understand and receive their benefits. In recent years a Veterans Advisory Commission
(VAC) was established to work with the Board of Supervisors and continue to provide services for local
veterans. Many of the veterans in the county are also seniors or developed some form of disability
necessitating assistance with daily living issues. The AAA staff works to help coordinate providing
services, such as the Vets Van that is available to transport veterans, with no other means of
transportation, to medical appointments in the county and to the San Francisco Bay Area.
The AAA staff continues to coordinate a monthly meeting called the Services To Older Adults
Advisory Council (STOAAC). This meeting is open to anyone that provides services for seniors and
persons with disabilities. The regular group includes staff from non-profit agencies, long term care
facilities, service organizations, government agencies, veterans organizations, companies that offer
goods and services to seniors, and AAA staff. The meeting is used as a forum to publicize events and
outreach opportunities, and network between the various groups.
The Stanislaus Elder Abuse Prevention Alliance (SEAPA) provides seminars, outreach events,
and other training opportunities to seniors, persons with disabilities, and caregivers regarding known
abuse and how to avoid becoming a victim. As stated above, SEAPA involves persons from many areas
who may be in the position to assist seniors and caregivers. The AAA staff continues to assist with the
planning of seminars and outreach events, working with the other agencies and interested persons to
help all citizens understand the ways that seniors can be abused.
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The Senior Coalition includes the director for the local Disability Resource Agency for
Independent Living (DRAIL). Many of their clients received and completed copies of the Older Adult
Needs Assessment Survey. The AAA staff has worked with DRAIL staff, participating in outreach
events and making referrals for services between the agencies, as appropriate.
According to data from the Alzheimer’s Association, Alzheimer’s disease is the 6th leading cause
of death for adults, mostly seniors. Over the last year the AAA staff has co-sponsored numerous
workshops and fund raising events, assisting caregivers and persons afflicted with this devastating
disease. Staff members from the Alzheimer’s Association are part of the Senior Coalition and are
frequent attendees at the monthly STOAAC meetings.
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SECTION 4. Planning Process/Establishing Priorities
The planning process for the AAA involved the staff, current consumers, the staff of current
provider organizations, the staff from associated agencies, and members of the general public. A
consultant was hired to help design, implement, evaluate and report on survey results. The survey was
distributed to current participants; seniors contacted through the contractor for the Long Term Care
Ombudsman, Homemaker and senior transportation programs; seniors receiving legal assistance;
persons involved with the local PRIDE (LGBT) Center; the Disability Resource Agency for Independent
Living (DRAIL); the Veterans Services Office; and several churches. Commission on Aging members
distributed surveys at senior centers in their districts. Surveys were available in English and Spanish.
Brainstorming/focus group events were part of the agenda at a Provider Meeting; a Services to
Older Adults Advisory Council (STOAAC) meeting; a meeting of the Long Term Care Ombudsman
staff and volunteers; a meeting of the Senior Coalition; the senior committees in Oakdale, Grayson and
Patterson; Adult Protective Services staff; In Home Supportive Services staff; the Senior Services staff
at Catholic Charities; and meetings of local Promotoras. The Promotoras are persons of Hispanic
heritage who meet with and assist members of their community with a variety of needs. The groups
meet in both urban and rural settings, assisting persons who are culturally and geographically
disadvantaged. The AAA staff provided translation services for the meeting in Grayson. AAA staff
requested additional information about the needs of the LGBT community from the trustee at the PRIDE
Center.
StanCOG, the Stanislaus Council of Governments, has spent the last year assessing the
transportation needs of various groups and persons within the urban and rural areas of the County. They
have used surveys and focus groups to help them write and implement a new “Public Transit-Human
Services Coordination Plan”. With the participation of seniors and persons with disabilities, specific
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focus groups have involved members of the public to address the growing transportation needs within
these groups. Data from the Interim Report, dated May 2015, has been included in several areas of this
Area Plan. The AAA staff will continue to be involved with implementation of the final plan to continue
the efforts on behalf of seniors and persons with disabilities within the county. Affordable, accessible
transportation options continue to be the need and desire of a growing number of seniors and persons
with disabilities in Stanislaus County. The new Transit Plan will be available by mid-2016.
As the Senior Coalition began their mission to work together to ensure cooperation around
developing true “person-centered” care, a number of brainstorming sessions were held to discover what
agencies and consumers believe are the strengths of current systems of care and where improvement can
be achieved. The AAA staff was part of each of these sessions. A specific focus group session was held
to contribute to the Area Plan, with the results reflected in Section 7: Public Hearings. Generally, the
Coalition sessions that contributed to their Strategic Plan showed that local agencies are doing many
things well, but everyone could do a better job of communicating with each other and their consumers.
Many agencies agreed that having a single point of entry for services for seniors, caregivers, and persons
with disabilities would go a long way for achieving the goal of giving comprehensive care.
The results of the Older Adult Needs Assessment Survey were used to plan programs beyond the
OAA contracted services. Using input from the organizations and agencies, various narrative objectives
have been designed to support the two goals, “Provide Information and Assistance” and “Promote
Health and Well-Being” for seniors, caregivers and persons with disabilities. The AAA staff will work
closely with other agencies to find ways to meet the expressed needs. APPROVED
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SECTION 5. Needs Assessment
As listed above, the AAA staff contracted to have a Senior Needs Assessment Survey done with
current participants of OAA programs, and with other populations throughout Stanislaus County.
Additionally focus group/brainstorming sessions were done with a variety of provider agencies and
service groups throughout the county. The AAA staff and members of the Commission on Aging are
active with StanCOG, a council whose mission is to meet transportation needs for all residents of
Stanislaus County. The staff members of StanCOG are in the final stages of completing a new Public
Transit-Human Services Coordination Plan. The AAA staff have participated in the needs assessment
efforts done by StanCOG. One of the persons that assisted in the AAA Needs Assessment was a trustee
for MoPRIDE, the local organization that is the resource for Lesbian, Gay, Bisexual, and Transgender
(LGBT) persons, including seniors. The trustee distributed copies of the survey in both English and
Spanish.
The Needs Assessment Survey was received by approximately 3,200 seniors and caregivers in
Stanislaus County. The survey was distributed by regular mail to current participants in OAA programs,
and hand delivered by other providers, as well as groups for whom the AAA did not have addresses.
Given that current participants live in all areas of the county, surveys went to rural and urban areas.
Surveys were available in Spanish for persons for whom English is not their primary language. From
other data it is known that our participants represent persons from all economic groups. Surveys were
distributed by staff from DRAIL and at two churches, as well as through MoPRIDE.
From that group, 776 were returned to the AAA and evaluated by the consultant. Most of the
respondents were between the ages of 70 and 89 (58%), were female (68.9%), and indicated that they
had a high school diploma (19.3%) or some college (28.4%). Approximately 6% of the respondents
identified themselves as part of the LGBT community, and only 25% of that group knew how to access
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services for LGBT elders. For single persons, approximately 38% of the respondents indicated that their
income was at or below 125% of the Federal poverty level, and 12% of two person households had
income at or below 125% of the Federal poverty level ($14,850 for a single person and $20,025 for a 2
person household). The majority of respondents live in Modesto, 55.2%, 13% in Oakdale, 9.3% in the
Turlock area and 5.8% in Ceres. The rural areas of Hughson, Newman, and Waterford represented
12.3%, collectively. Most of the seniors live alone, 46.1%, with 31.4% living with a spouse or
significant other. For transportation needs, 80.4% use their own vehicle or ride with relatives or friends.
Only 9.3% indicated that they use public transportation or Dial-a-Ride. To maintain or improve their
health, 67% indicated that they do some form of exercise a few times a week or every day.
For questions that asked about ethnicity, 15.6% of respondents identified as Hispanic. Native
Americans, either full or part, accounted for 5.1% of the respondents. Asian and African American
respondents included 2.9% for each of these ethnic groups. Approximately 10% of respondents’
primary language is other than English with 6.6% speaking only Spanish. For information available in a
respondent’s preferred language, 12.1% indicated that they did not get that information, 11.7% believe
they don’t have access to programs that are appropriate to their ethnicity, and 31.8% don’t know about
such programs.
These numbers do not agree with the Census figures for the general population over the age of
60 in Stanislaus County. As detailed in the first section, 22.9% of the population over 60 can be
identified as having Hispanic heritage. According to the California Department of Finance, in Stanislaus
County the Asian communities include 5.3% of the population is over 60, and 2.3% of the population
over 60 identify as African American. County residents who identify has having a heritage of Native
American represent less than 1% of the population over the age of 60.
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For Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL), the
majority of survey respondents indicated they have difficulty with heavy housework (73.7%). The next
highest area was walking, 55.2% have some difficulty. Activities such as light housework, shopping,
preparing meals, and transferring in and out of bed each were indicated as being difficult to do or unable
to do by 40-48% of respondents.
For general issues and concerns, most respondents did not consider elder abuse, crime, remaining
in their own home, or feeling safe in their home to be problems. About 50% viewed finding work to be
a problem. Approximately half of the respondents viewed having enough money to meet expenses to be
a problem, along with losing their memory. Close to half of the respondents considered getting
information about and receiving benefits for seniors to be a concern. For caregivers getting information
and accessing services, including training, were main concerns. Over 22% of respondents indicated that
getting enough food was a problem.
For the 644 respondents who answered all the questions, 62% referred to themselves as
completely independent. Mostly independent seniors who didn’t need help with self-care, but with other
parts of their lives were approximately 15% of respondents. Those seniors that rely on relatives and
friends for much of their needs were 14% of the respondents, and approximately 9% of respondents rely
on paid support to meet their needs. Those seniors who are independent are younger than others, have
higher income, and more education than other groups. Those seniors that need help with some aspects
of their lives, but not with self-care, most often rely on a partner or spouse, are older than the
independent seniors, have lower income than the fully independent seniors, and have more education
than those that rely on family or friends or paid support. The seniors that rely heavily on family and
friends are older than the previous two groups, have less education, and lower income than those groups.
They also are more likely to be female than male. The group that rely on paid workers have less
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education and lower income than the first two groups, are more likely to speak Spanish, and were more
likely to be a veteran than the first two groups.
Though a majority of survey respondents indicated they are completely independent (62%), 38%
of seniors stated they rely on other persons for various aspects of daily life. About 50% of the
respondents indicated that their income is less than 125% of the Federal Poverty Level (FPL). That fact
can be reflected in the responses that indicated approximately 50% are concerned about finding work
and 50% are concerned about having enough money to meet expenses. Almost 50% said they need
information about senior services and how to access those services. The AAA staff understands the
need to help the general public, and seniors in particular, know about and take advantage of the
programs that can help find ways to stretch their fixed incomes. The staff at the Information and
Assistance office frequently helps callers to access programs that are funded through our office, but
more often callers are directed to programs outside of the AAA. Seniors who eat at lunch sites can
stretch their food dollars while interacting with other people and participating in other aspects of
community life.
The Health Insurance Counseling and Advocacy Program (HICAP) staff and volunteers
regularly assist seniors to make choices that can help them save money. The Case Management
Program is available for seniors that need the extra assistance to find solutions to various needs. The
Green Bag Program, a bag of fresh fruits and vegetables distributed monthly, will be expanding from 3
locations to include 2 other towns. Currently the food is distributed in Modesto, Grayson (rural west
side), and Oakdale (rural east side). The Healthy Aging Association will begin the program in Patterson
and Riverbank within the new fiscal year. Another food-related program is the Senior Farmers Market
Coupon program. The AAA staff visit the certified markets early in the market season to distribute the
coupons to qualified seniors. The markets are located in Patterson, Turlock, Modesto, Riverbank, and
Oakdale, and provide assistance to seniors and the farmers of our area. The Green Bag and Farmers
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Market Coupon programs use a higher income level than the FPL as the maximum income to qualify for
the programs, a level that is close to the level identified by the Elder Self Sufficiency Index (Elder
Index). For a single person the Elder Index amount is $20,736 annually and for a couple, the Index is
$28,788 annually in Stanislaus County.
For health related questions, approximately 48% said they are concerned about losing their
memory, and 42% indicated they frequently feel sad and/or lonely. These issues can be the cause of
depression for senior citizens. For a number of years the AAA has received funding through the Mental
Health Services Act to conduct a number of Prevention and Early Intervention (PEI) programs, called
Project Hope. Project Hope includes counseling from a clinician, counseling with trained senior
volunteers, and a friendly visitor program. The AAA staff also promotes a program known as Senior
Center Without Walls. This program is a conference call to a central place and anyone who registers for
the free service receives a schedule of topics for each quarter. The target audience is the homebound
senior citizen, but the service is available to anyone. The intent is to prevent depression or address mild
depression before the condition becomes more serious. These services occur in a senior’s home and are
designed according to their needs. In addition to the barrier that many people don’t know about the
service, many people don’t want to admit that they might need help coping with life’s challenges.
For seniors that identified walking and transferring from a chair or bed as major issues, help can
be in the form of assistance to the senior’s caregiver through the Family Caregiver Support Program. In
Stanislaus County the majority of the funding for this program is spent on respite for caregivers of frail
elders. Home health agency personnel can assist with ambulating and transfers. Seniors who qualify for
In Home Supportive Services program due to their income level are encouraged to apply for that
program, as the help can be on-going and more regular than is available through the Family Caregiver
Support Program. Seniors are also encouraged to participate in exercise classes that can strengthen
muscles and increase balance. The Healthy Aging Association sponsors several programs that can assist
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seniors improve their mobility through exercise, re-orient their thinking, and develop healthy eating
practices.
As the Senior Coalition of Stanislaus County has met and worked through ways that agencies
can be more proactive and collaborative towards the end of assisting vulnerable seniors, various ideas
have been expressed. Those ideas were cataloged by the coordinator for the Coalition and became the
basis for the strategic plan to be implemented over the next few years. Objectives for the Coalition,
involving staff from the AAA include: improve education and support for caregivers; investigate
affordable adult day care; pay greater attention to assisting seniors with mental health issues; improve
access to long term services and supports for older adults and persons with disabilities; explore the
means to become the source for information and services. The AAA staff will be using the information
gleaned from the assessment done through the Senior Coalition to work with the various members,
meeting the needs and participating in solutions that are achieved through the Coalition.
Beyond the greatest need-that of focused and sustainable funding-a need expressed in several
meetings has been the inability for some agencies to go beyond their particular area and work on
collaborating with the AAA or other agencies that assist seniors. For a number of years many in the
senior services community have used the Information and Assistance flyer, the “pink” in English and
“blue” in Spanish, to find the resources to satisfy various needs. Yet often many people neglect to
contact the AAA directly at the phone number listed on the front to get in-person information about the
services listed in the “pink”, or other services available to seniors, caregivers, and persons with
disabilities. The AAA staff will continue to collaborate with various agencies and work to be the first
agency contacted to meet the needs of seniors, caregivers, and persons with disabilities.
The need for affordable, appropriate housing for seniors was expressed at a number of the
brainstorming sessions. Particularly acute was the need for assisted living for people who are low
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income, those whose income is above the federal poverty level ($11,880.00 for a single person and
$16,020.00 for a 2 person household), but inadequate to pay for assisted living care facilities. One focus
for the Senior Coalition is to explore how to receive the Assisted Living Waiver 1115. This waiver is
available in other counties and provides Medi-Cal funding for assisted living facilities. Coalition
members that will be working on this include a member of the Commission on Aging and members
from a local hospital, as well as an advocate for better care for persons with Alzheimer’s disease.
Within the group that could need a different level of housing and care are the persons that develop or
have a mental illness. A related need is for seniors to be able to pay for some in-home assistance, short
of needing skilled nursing care. All persons value retaining independence and the ability to choose
where to live. Programs are needed that can address the need to assist seniors remain independent as
long as is safe.
The Senior Adult Needs Assessment Survey and subsequent focus group meetings have served
to emphasize to the AAA staff the need to find creative ways to let the public know about the many
services available for seniors, caregivers and persons with disabilities in Stanislaus County. These
services include the Older Americans Act programs, but also many others. The AAA staff has
attempted to retain as much current program information as possible. At outreach events and when the
AAA staff speaks to community groups, we emphasize the use of our main phone number to receive
information and referral to various programs. Financial concerns were also significant issues for many
of the survey respondents and the representatives of various agencies.
Generally the other areas that were identified as prominent needs included various aspects of
helping seniors to remain healthy and independent for as long as is safely possible. These include
needing some assistance with self-care, emotional needs, and maintenance of the home.
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The AAA staff determined that the main goals for the next four years first should focus on
getting information out to the general public, including groups of people that are over 60, caregivers of
frail elders, and persons with disabilities. Specific suggestions for outreach include contacting faith
communities, schools to contact the adult children of frail elders, and establishing liaisons in various
communities to collaborate on information dissemination. The other main goal for the AAA will be to
provide services, and collaborate with other agencies to provide services that encourage people to
understand how they can stay as healthy as possible.
To determine how the OAA Section Title III B funds will be used to meet the “adequate
proportion”, the AAA staff considered the fact that funding has remained the same for a number of
years. Additionally, the needs expressed by the survey, through the focus groups, and as the staff has
interacted with consumers have either remained constant or increased at approximately the same rate.
Therefore, for Case Management, Information & Assistance and Outreach services, as part of Access,
will receive 33.04% of Title III B funds. For In-Home services the AAA will spend 20.47% of Title III
B funds for Homemaker services. Legal services will receive 22.02% of Title III B funds.
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SECTION 6. Targeting
As required by the Older Americans Act Assurances listed at the end of this Area Plan, the AAA
staff strives to make services available to all persons over the age of 60, with special attention to persons
who demonstrate the greatest economic need; social or cultural need; to be at risk of institutionalization;
to be part of a minority group with economic need; to be limited in their ability to speak English; live in
a rural area; to have a severe disability; suffer from Alzheimer’s disease or a related form of dementia.
In Stanislaus County, approximately 22% of seniors over 60 qualify for Medi-Cal, according to
the latest estimates from the Department of Health Care Services. The Insight Center for Community
Economic Development, collaborating with the UCLA Center for Health Policy Research, developed the
Elder Self-Sufficiency Index (Elder Index)6. Data from this source is available according to the cost of
living in each county. The Elder Index includes more of the costs needed by individuals and families to
maintain their basic standard of living than the Federal Poverty Level (FPL) ($11,880 for a single person
and $16,020 for a couple). These costs include housing, transportation, insurance, food, etc., whereas
the FPL only considers the cost of food, and is the same throughout the continental United States. For
Stanislaus County, using census data from 2011, it was determined that, for persons over 65, 8% were
below the FPL. For seniors whose income was above the FPL, 42% had income that was below the
Elder Index. The estimated income necessary for a single senior to make ends meet is approximately
$20,736.00. For couples the Elder Index level is $28,790.00. The seniors whose incomes are above the
FPL, but below the Elder Index level, are becoming known as the “hidden poor” because many do not
qualify for assistance under federally funded programs. Programs such as the Green Bag and SNAP-Ed
seek to assist low income seniors by providing fresh fruits and vegetables, along with education
opportunities to encourage healthy food choices, despite their financial and location challenges. The
6 http://www.insightcced.org/past-archives/insight-networks/building-economic-security-for-all-besa/measuring-and-addressing-older-californians-needs/what-seniors-need-to-make-ends-meet-elder-index-in-stanislaus-county/
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financial threshold for qualification for these programs is higher than the FPL and in line with the Elder
Index. The programs are available in both urban and rural settings. Green Bag will expand in late 2016
to include Patterson and Riverbank, both rural areas and both with significant low income minority
seniors. The annual Farmers Market Coupon program also has set a financial threshold close to the Elder
Index level and is available at certified markets in five cities spread throughout the county.
Approximately 34% of seniors identify themselves as being part of a minority group. The largest
minority group is those people who identify as of Hispanic heritage, 22.9% of seniors 60 and older.
Asian Americans make up 5.3% of the senior population, African Americans, 2.3%, and for all other
minority groups, the total is less than 4%. Approximately 5% of seniors do not speak English, with an
unknown number for whom English is their second language, likely limiting their ability to fully
understand possible services only available in English. For many years it has been a contractual
requirement for the AAA providers to print any flyers or brochures in both English and Spanish, and to
ensure that the AAA has copies in both languages. When AAA staff members attend outreach events,
they carry brochures in English and Spanish and make every effort to have bilingual staff available to
answer questions.
Though the Hispanic population remains the largest minority group in Stanislaus County, several
other ethnic minority groups are growing. Consumers that identify as Assyrian, members of
communities associated with India, immigrants from China, Vietnam, Laos and Cambodia include
seniors in their numbers. Many seniors in these groups experience the isolation that comes from a lack
of services available in their language and in accordance with their culture. Many also wrestle with the
changes in their lives associated with their children and grandchildren assimilating into American
culture, leaving behind long-established traditions and the expectations of the seniors. The Commission
on Aging includes a member whose heritage is Chinese. She is active in the local Chinese community
and assists consumers from various areas of Asia, including assistance with the Senior Needs
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Assessment Survey. The AAA staff, as County employees, has access to a language service to assist
with communication efforts.
The communities of Hughson, Newman, Westley, Grayson, Denair, Keyes, and Waterford are
considered to be rural. These communities with ranch areas outside of the towns include approximately
8,100 seniors or 8.3% of the population over 60. Outreach events are often coordinated by city staff or
by SEAPA, the coalition of agencies organized to inform seniors and caregivers about elder abuse
prevention. These events are available to the public throughout the county and the AAA staff and
volunteers are active participants. These are often the means to connect with seniors in the rural areas.
For events in any of the larger cities, the AAA has provided bus service to bring participants in from
both the east and west sides of the county.
The Senior Adult Needs Assessment Survey included questions about sexual orientation and
inclusion in the Lesbian, Gay, Bisexual, and Transgender (LGBT) community. Through the efforts of a
member of MoPRIDE and a member of the Commission on Aging, in-put was sought from the LGBT
community. Members of churches that are known to welcome gay members were asked to complete
surveys. The significant need identified by the respondents was the need to have information about
services. The AAA staff has made efforts to reach out to members of the LGBT community with
information and services, assuring all persons that the services are available to seniors and caregivers
regardless of income, ethnicity, location, gender or sexual orientation.
The AAA staff includes the staff of the Multipurpose Senior Services Program (MSSP), the
Medi-Cal waiver program of case management to assist low income frail seniors to remain in their
homes as long as possible. The MSSP program includes social workers, a public health nurse, and
volunteers who assure their clientele the opportunity to enjoy the best quality of life possible, despite
their challenges. Another feature of this program is an agreement with the California State University,
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Stanislaus departments of Social Work and Nursing. Interns from the Social Work major and students
in the Nursing program gain real world experience and learn from the staff and seniors that are part of
the MSSP program. In fiscal year 2015-2016 the AAA began a case management program to assist
seniors who do not qualify for MSSP or who need assistance before the MSSP program can be accessed
for them. This program is intended to assist seniors on a short term basis, but can be available for as
long as the senior needs the assistance.
A growing need in Stanislaus County is for support for persons with a diagnosis of dementia and
support for their caregivers. The staff of the AAA has worked closely with the staff of the Alzheimer’s
Association to sponsor educational opportunities for both caregivers and those suffering from
Alzheimer’s disease and related forms of dementia. The AAA staff has also provided a venue for the
staff from the Valley Caregiver Resource Center to conduct workshops to assist caregivers of frail
elders. Respite opportunities for caregivers, including assistance through home health agencies, have
been the focus of the Family Caregiver Support Program.
Barriers to accessing services include the challenges associated with conveying information to
potential consumers; the needs of persons for whom English is difficult to understand; and finding ways
to coordinate the efforts of various agencies. The AAA staff includes multiple bilingual staff, beginning
with the director and including I&A staff, HICAP manager and volunteers, case manager, PEI staff, and
MSSP staff. The AAA staff continues to make information about services available through the
publication of the Information and Assistance flyer known as the “pink” in English, or “blue” in
Spanish. Many agencies attest to the AAA staff that this brochure has been helpful in making referrals
for consumers, but it is often heard that new consumers are unaware of services during critical times in
their lives. A need identified at several of the focus groups was the need for a “single point access”
service where any consumer can get information about all senior services. While the AAA staff has
attempted to be that one place by advertising the Information and Assistance phone number, consumers
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and agency personnel still identify the need for more complete coordination and information to meet the
growing needs of seniors and caregivers.
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SECTION 7. Public Hearings PSA 30
At least one public hearing must be held each year of the four-year planning cycle. CCR Title 22, Article 3, Section 7302(a)(10) and Section 7308, OAA 2006 306(a)
Fiscal Year Date Location Number of Attendees
Presented in languages other than English?7
Yes or No
Was hearing
held at a
Long-Term Care
Facility?8 Yes or No
2016-17 1/21/16 Ombudsman Staff Meeting, Catholic Charities, Modesto
12 No no
2/2/16 Provider Meeting, AAA office, Modesto
9 No no
2/3/16 STOAAC Meeting, Modesto 19 No no
2/8/16 APS Staff Meeting, Modesto 10 No no
2/16/16 Senior Committee, Patterson 9 No no
2/18/16 IHSS Staff meeting, Modesto 36 No no
2/23/16 Senior Coalition meeting, Modesto 17 No no
3/3/16 Senior Services Staff Meeting, Catholic Charities
7 No no
3/11/16 Grayson Community Center 12 Yes no
3/15/16 Gladys Lemmons Senior Center, Oakdale
9 No no
3/28/16 Promotoras Group, Ceres 10 No no
4/11/16 AAA Office, Modesto 19 No no
2017-18
2018-19
7 A translator is not required unless the AAA determines a significant number of attendees require translation services.
8 AAAs are encouraged to include individuals in LTC facilities in the planning process, but hearings are not required to be held in LTC facilities.
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2019-20
The following must be discussed at each Public Hearing conducted during the planning cycle:
1. Summarize the outreach efforts used in seeking input into the Area Plan from institutionalized, homebound, and/or disabled older individuals.
Catholic Charities, the provider for the Homemaker and Long Term Care Ombudsman programs,
distributed copies of the Senior Needs Assessment Survey to their clients. A focus group was held
with the staff and volunteers from the Ombudsman Program, and another with the staff of the larger
Senior Services programs at Catholic Charities. These programs represented the needs of the
institutionalized individuals. Clients of the Home-Delivered Meals program received surveys by
mail.
The focus group with the Senior Coalition included the director for the Disability Resource
Agency for Independent Living (DRAIL). Staff from DRAIL assisted with the Needs Assessment
Survey by distributing it to their consumers.
2. Were proposed expenditures for Program Development (PD) or Coordination (C) discussed? X Yes. Go to question #3 Not applicable, PD and/or C funds are not used. Go to question #4 3. Summarize the comments received concerning proposed expenditures for PD and/or C Attendees endorsed the efforts by the AAA staff to recruit additional bilingual volunteers for the various programs. The AAA staff clarified the services available through the Prevention and Early Intervention programs. 4. Attendees were provided the opportunity to testify regarding setting minimum percentages
of Title III B program funds to meet the adequate proportion of funding for Priority Services X Yes. Go to question #5 No, Explain: 5. Summarize the comments received concerning minimum percentages of Title IIIB funds to
meet the adequate proportion of funding for priority services. The AAA staff clarified the distribution of the proportion of funding and there were no comments
related to those percentages.
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6. List any other issues discussed or raised at the public hearing.
Feedback from the various groups included ideas ranging from needing more of the current services
to a reorganization of the ways that services are coordinated. Attendees stated that often seniors and
caregivers are unaware of the services that are available. It was also noted that many seniors are too
proud to accept assistance from agencies, as well as many seniors are in denial about needing services to
remain independent. Suggestions were made to contact seniors, caregivers and persons with disabilities
through faith communities and civic organizations. A number of attendees were concerned about
services for specific groups such as veterans, persons who do not speak English, or persons with
disabilities. Attendees believe that seniors who do not speak English won’t contact a government
agency due to the fear of immigration consequences. It was suggested that the AAA staff establish
relationships within various communities via designated liaisons, such as the Promotoras, the group that
assists Hispanic members of the community.
There continues to be expressed needs for affordable housing. This includes housing for
independent seniors and persons with disabilities, as well as affordable assisted living arrangements.
A major focus in all the meetings was how to better help seniors remain independent. Their
concerns and ideas included implementing programs that use a contact system that checks on seniors
living alone, on a daily basis. Better collaboration between agencies was discussed as a means to
address the needs of the seniors, without duplication or competition. Enhanced delivery of services
could be accomplished with a consolidation of services and/or information in one location. The hope of
many attendees is to establish a system to allow consumers to access services through one phone
number, with a minimum of re-direction to other agencies. Another suggestion was a re-organized web
site with up to date information about senior services.
For caregivers, attendees expressed a need for training and additional support groups. Also needed
is affordable adult day care in the County. There is a need to make contact with the adult children of
elders, making them aware of services for the seniors, as well as caregivers.
As seniors age in place, better care coordination is needed, especially in situations where seniors
leave hospitals or care facilities to return home. Included in concerns expressed were thoughts about
how pets will be treated if a senior needs to make a change, such as moving to assisted care. With the
“one-stop-shop” concept, caregivers and seniors avoid the situation associated with contacting various
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agencies. Additionally, a need was expressed that many seniors require assistance with completing
forms, due to either language barriers or a lack of understanding various forms.
Adequate or appropriate transportation for seniors, especially those that need extra assistance, is
lacking. This belief was expressed, especially in rural areas. The services that exist often cover only
medical appointments, due to a lack of drivers, or adequate funding. Many seniors are reluctant to ask
for assistance due to their perception that others are unwilling to assist them.
Though many people deny that they need mental health assistance, counseling to handle various
kinds of grief was an expressed need. For many of the services that are not readily familiar, the
suggestion was made to design posters to go into various stores and offices: pharmacies, grocery stores,
doctor offices, etc. It was also recommended that AAA staff access referral services from other
agencies.
7. Note any changes to the Area Plan which were a result of input by attendees.
Both of the Narrative Goals in Section 9 involve a number of objectives that seek to provide better,
more comprehensive information about senior services. The AAA staff will continue to be involved
with StanCOG and MOVE, to address the transportation needs expressed in the brainstorming sessions.
To address the needs expressed to coordinate and provide more comprehensive services, the AAA staff
will be working with the Senior Coalition members to understand the ways to make the delivery of
services more “person centered”, allowing the seniors to live independently and safely for as long as
possible.
APPROVED
38
SECTION 8: Identification of Priorities
Since 2012, the last Area Plan, the number of persons age 60 and older has increased 2.6% from
an estimate of 88,945 in 2012, to 97,110 for 20169. The elder population is anticipated to be
approximately 17.8% of the total population. With the growth of the population the needs have also
grown. The AAA staff will continue to encourage the established associations between agencies in the
County, finding ways to meet the growing needs of the senior population.
A recurring theme from the focus groups was that the information about senior services, through
the AAA and in conjunction with the AAA, is not widely known by the general public. Another issue is
the lack of coordination between agencies serving the needs of seniors and persons with disabilities,
resulting in seniors not receiving services. Beyond providing vital information about services, the AAA
is committed to assisting seniors, caregivers, and persons with disabilities achieve and maintain the best
possible quality of life. This includes continuing services that are listed below and collaborating with
agencies to better insure that services are not duplicated, but made available in a way to help seniors
remain independent where they want to live.
As listed earlier, the AAA and the contracted providers have made information about particular
services available in English and Spanish. The AAA has bilingual staff members, English and Spanish,
available within each of the programs done as direct services. The contracted providers have been
encouraged to seek staff who are bilingual. Congregate meals sites are located throughout the County:
in urban and rural areas, Newman in the south western area, Patterson and Grayson in the rural western
area, several sites in Modesto, Riverbank and Oakdale in the eastern part of the County, and Turlock
south of Modesto. Home-Delivered meals are delivered to seniors in rural and urban settings throughout
the County. Homemakers serve seniors throughout the County, as do the home health agencies
9 http://www.aging.ca.gov/docs/DataAndStatistics/Statistics/IFF/2016_Population_Demographic_Projections.pdf
APPROVED
39
contracted through the Family Caregiver Support Program. The Health Insurance Counseling and
Advocacy Program (HICAP) staff and volunteers meet with seniors in the Modesto office, and have
satellite meetings in Turlock, Oakdale and Patterson. They also will do home visits with seniors that
can’t go to one of those offices. Health Promotion services are offered in each of the communities of the
County, mainly through the Young at Heart strength-training program, but also through the SNAP-Ed,
and A Matter of Balance classes. Free fresh fruits and vegetables are distributed to low income seniors
through the Green Bag Program in two areas of Modesto, and in the rural areas of Oakdale and Grayson.
In the new fiscal year this program will expand to include providing free fruits and vegetables monthly
in Patterson and Riverbank.
The process to determine the adequate proportion for use of OAA Section Title III B funds
includes considerations resulting from the various ways that needs have been determined. The Senior
Needs Assessment Survey and focus groups throughout Stanislaus County have been the main means
used to determine how best to allocate the limited funds. In addition, data from a survey and groups
done by StanCOG have been added where appropriate. The funds allotted to the AAA in the Older
Americans Act have remained constant, in spite of the fact that the population has increased, along with
the needs in roughly the same proportion. In the Access category, funds will be spent for Case
Management, Information & Assistance, and Outreach. For In-Home services, the AAA funds are used
for the Homemaker program. For Legal services, the AAA contracts with the Senior Advocacy
Network to provide legal assistance, including a close relationship with the Long Term Care
Ombudsman and Adult Protective Services programs.
Beyond the resources associated with the Older Americans Act, the AAA has been
instrumental in assisting non-profit agencies in the area with obtaining grant funding to meet needs in
various ways. The AAA has a contract with a grant writer that has resulted in provider agencies being
able to strengthen and extend their services beyond the federal and state funds. Several years ago the
APPROVED
40
Commission on Aging and AAA staff helped create the Senior Foundation of Stanislaus County. This
foundation, through their fund-raising efforts has been able to meet needs such as preventing utility shut-
off, rental assistance, and purchasing I-pods to give to care facility residents to improve their quality of
life. The AAA staff continues to work closely with the staff of APS, IHSS, and other adult services to
find creative solutions to many of the challenges faced by seniors and the agencies that assist them.
APPROVED
41
Section 9-Area Plan Narrative Goals and Objectives
Goal # 1
Goal: Provide Information and Assistance to Senior Citizens, Caregivers, and Persons with Disabilities Rationale:
Results of the Older Adult Needs Assessment survey and the focus groups showed that information about senior services is lacking.
Objectives:
Projected Start & End Dates
Title III B Funded PD or C
Update Status
Objective 1.1: The AAA staff and the Senior Coalition of Stanislaus County will distribute copies of the Fall Prevention Guide.
7/1/16-6/30/20
Coordination New
Outcome: Fall prevention information will be distributed by service providers and at outreach events throughout the county, and available on line at the Healthy Aging Association website.
Measurement: The number of guides distributed. Objective 1.2: The AAA staff will coordinate with the Stanislaus Elder Abuse Prevention Alliance (SEAPA) to conduct outreach events in various communities to increase awareness of the signs of elder abuse, how to prevent abuse, and give the resources to better serve the victims of abuse.
7/1/16-6/30/20 C New
Outcome: Seniors, caregivers and the general public will learn about elder abuse prevention. Measurement: The number of outreach events and the number of attendees.
Objective 1.3: The AAA staff will work with the members of the Senior Coalition of Stanislaus County to sponsor the Healthy Aging and Fall Prevention Summit, October 21, 2016. Free health screenings and information about fall prevention and a variety of health topics will be presented to the public.
7/1/16-10/21/16 C New
Outcome: Seniors and caregivers will attend the Summit.
APPROVED
42
Measurement: The number of attendees and health evaluations completed. Objective 1.4: The Health Insurance Counseling and Advocacy (HICAP) staff and volunteers at the AAA will partner with staff members in the cities of Oakdale, Turlock and Patterson to establish HICAP services in these cities.
7/1/16-6/30/20 C New
Outcome: Senior citizens and caregivers in Oakdale, Turlock and Patterson will have improved access to information about Medicare benefits. Measurement: The number of seniors that access the services.
Objective 1.5: The AAA staff will coordinate with the staff of MOVE Transportation Services to promote their Mobility Training and Bridges programs.
7/1/16-6/30/20 C New
Outcome: Senior citizens will successfully access various forms of transportation. Measurement: The number of outreach events and resulting registrations for services. Objective 1.6: The AAA staff and members of the Commission on Aging will work to advocate for continuing assistive transportation services by serving on the Social Services Transportation Advisory Committee of StanCOG and the MOVE Mobility Advisory Committee.
7/1/16-6/30/20 C New
Outcome: The AAA and Commission on Aging will secure greater funding for door through door transportation for seniors and disabled persons who cannot use other means of assisted transportation. Measurement: The amount of funds available to establish and continue specialized transportation services. Objective 1.7: The AAA staff and Commission on Aging members will partner with the Stanislaus Senior Foundation’s staff to assist seniors whose needs exceed available assistance.
7/1/16-6/30/20 C New
Outcome: Low income seniors will receive assistance to remain independent as long as possible. Measurement: The number of seniors that are referred by AAA staff to the Stanislaus Senior Foundation Objective 1.8: The AAA staff will promote programs and encourage participation by diverse populations within the County, including seniors of various ethnic backgrounds and LGBT seniors and caregivers.
7/1/16-6/30/20 C New
APPROVED
43
Outcome: Information about available senior services will be conveyed via participation in outreach opportunities. Measurement: The number of events attended by AAA staff. Objective 1.9: The AAA staff will recruit new bilingual volunteers for the PEI and HICAP programs by making presentations at the various Hispanic, Assyrian, Asian and other organizations that serve ethnic populations in the County.
7/1/16-6/30/17
Program Development New
Outcome: The result will be that seniors for whom English is difficult will be served through these programs. Measurement: The number of recruitment meetings with various organizations and the number of bilingual volunteers.
Objective 1.10: The AAA HICAP staff will collaborate with the staffs of the Healthy Aging Association and Catholic Charities to conduct outreach events to low income seniors. The targeted population will include current participants in the Green Bag program, to increase awareness of other services such as the Limited Income Subsidy and Cal Fresh programs.
7/1/16-6/30/20 New
Outcome: Low income seniors will enroll in benefits that will assist them remain independent and financially capable. Measurement: Number of events and the number of seniors enrolled in additional benefits. Objective 1.11 The AAA staff will coordinate with the SNAP-Ed/CNAP partners to promote Harvest of the Month (HOTM) produce by highlighting HOTM fruits/vegetables on the monthly senior meals menus and at Farmers Market Nutrition Program coupon distributions during the summer months. The objective provides additional nutrition education highlighting the health benefits of fresh fruits and vegetables.
7/1/16-6/30/20 New
Outcome: HOTM produce will be highlighted on at least 3 monthly menus and at 1-2 Farmers Markets. Measurement: Number of monthly menus created and distributed.
APPROVED
44
Goal: #2
Promote Health & Well-Being for Senior Citizens, Persons with Disabilities, and Caregivers Rationale: The responses on the Older Adult Survey included concerns about basic physical aspects of daily living. Addressing these concerns and seeking ways that can help people be healthier can help senior citizens stay as independent as possible.
Objective 2.1 The AAA staff will request a resolution from the Board of Supervisors to declare May to be Older Americans Month, bringing attention to the accomplishments and needs of senior citizens in Stanislaus County. The AAA staff and Commission on Aging will coordinate to honor one outstanding senior from each supervisor’s district at a Board of Supervisor’s Meeting to highlight the contributions they have made to their communities.
1/1/16-5/14/20 C New
Outcome: Sponsoring the special event will emphasize the on-going contributions of the senior population. Measurement: Participation by the public to nominate candidates to be honored and the completion of the special session of the Board of Supervisors. Objective 2.2 As the recipient of Title IIID funding, the Healthy Aging Association will conduct the “A Matter of Balance” classes throughout the County. Additionally, the Healthy Aging Association will conduct a Tai Chi: Moving for Better Balance Class. Both of these programs have been identified as evidence-based programs. 7/1/16-
6/30/20 New Outcome: Seniors will participate in classes that will help them understand their fear of falling and how to prevent falls. Measurement: The number of classes available and number of participants.
Objective 2.3: The contractor for the Long Term Care Ombudsman Program will develop Emergency Preparedness plans to assist care facilities to be ready to properly assist residents.
7/1/16-6/30/20 New
Outcome: The Ombudsman staff and volunteers will understand how to assist the staff of care facilities to be prepared for disasters. Measurement: The completed plan and the number of care
APPROVED
45
facilities with appropriate plans. Objective 2.4 The AAA staff will coordinate with local senior service providers, senior housing complexes, and medical or social service staff of primary care offices or long term care facilities to promote the utilization of the older adult Prevention and Early Intervention (PEI) programs available in Stanislaus County.
7/1/16-6/30/20 C New
Outcome: AAA staff will offer group presentations and participate in local senior outreach events to promote the PEI programs (Brief & Peer Counseling and Friendly Visitors).
Measurement: AAA staff will provide a minimum of 12 presentations and attend 6 outreach events annually. Objective 2.5: The AAA staff will expand the navigation role of the PEI programs by utilizing AAA volunteers, Senior Information and Case Management staff to provide follow-up support for those PEI referrals at highest risk of non-compliance with program goals.
7/1/16-6/30/17 PD New
Outcome: New AAA volunteers will be trained to provide follow-up phone call support and to make referrals as needed to the Information & Referral and Case Management staff. Measurement: Six to ten new Senior Peer Counselor, Friendly Visitor or other AAA volunteers will be trained for this role to provide additional phone support/follow-up to PEI clients.
Objective 2.6 The AAA staff will partner with the Healthy Aging Association and the Second Harvest Food Bank to expand the Green Bag program.
7/1/16-6/30/17 PD New
Outcome: Low income seniors will have access to fresh fruits and vegetables. Measurement: The number of seniors receiving produce and the number of new sites for distribution throughout the county.
Objective 2.7: The AAA staff will coordinate with local SNAP-Ed partners and providers to promote increased fruit and vegetable consumption and increased physical activity by planning and promoting Senior Community Gardens, promoting utilization of Senior Farmers Market Nutrition Program coupons, and Senior Walking Groups.
7/1/16-6/30/17 C New
Outcome: Seniors will have greater opportunities to change their health by greater access to fresh fruits and vegetables. Seniors will increase their exercise routines.
APPROVED
46
Measurement: At least one senior housing or community center host a Senior Garden and/or Walking Group. At least one special event at a certified Farmers Market to promote the utilization of Senior Farmers Market Coupons. Objective 2.8: The AAA staff will coordinate with the California State University Stanislaus Nursing students and/or Modesto Junior College Social/Human Services students to assist with the initial screening (including PHQ-2 Depression Screen) of the Home Delivered Meals program participants to increase the number of appropriate referrals to other senior service agencies, including PEI programs and Senior Information and Referral services.
7/1/16-6/30/20 C New
Outcome: Seniors will be referred to and receive case management and counseling/social support.
Measurement: The number of seniors assessed by CSUS & MJC students. Objective 2.9: The AAA staff will coordinate with members of the Senior Coalition of Stanislaus County to understand and access available services, assisting seniors to age with dignity, choice and independence.
7/1/16-6/30/20 C New
Outcome: Members of the Coalition will coordinate to provide accurate information and services for seniors and caregivers in Stanislaus County.
Measurement: The variety of service providers in the Coalition and the number of events/services available to seniors and caregivers. Objective 2.10: The AAA staff will participate in the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) work plan process with the other local implementing agencies (Public Health, Catholic Charities, & UC cooperative) to create an integrated work plan (IWP) that incorporates all of the partners’ goals and strategies, and identifies which entities will carry out each activity and at which location.
7/1/16-6/30/17
New
Outcome: AAA staff will participate in the SNAP-Ed work plan meetings and planning process. Measurement: Number of SNAP-Ed meetings, conference calls, or webinars attended.
APPROVED
47
Objective 2.11: The contractor for the Long Term Care Ombudsman Program staff and volunteers will provide outreach events to educate the community regarding the mission of the Program, protecting the rights of residents of care facilities. Outreach opportunities will include informing the public of legislative initiatives that affect the residents of care facilities.
7/1/16-6/30/20 New
Outcome: Information about residents’ rights will be available to the communities in Stanislaus County.
Measurement: The number of community outreach events and participants in those events. Objective 2.12: The AAA staff will coordinate with MOVE to recruit volunteers for a transportation program assisting veterans to access health services in Livermore and Palo Alto.
7/1/16-6/30/20
C
New
Outcome: Veterans will receive the treatments available in the Bay Area.
Measurement: Number of volunteers recruited and the number of veterans receiving services in the Bay Area.
APPROVED
48
SECTION 10 - SERVICE UNIT PLAN (SUP) OBJECTIVES PSA 30
TITLE III/VIIA SERVICE UNIT PLAN OBJECTIVES CCR Article 3, Section 7300(d)
The Service Unit Plan (SUP) uses the National Aging Program Information System (NAPIS) Categories and units of service. They are defined in the NAPIS State Program Report (SPR)
For services not defined in NAPIS, refer to the Service Categories and Data Dictionary and the National Ombudsman Reporting System (NORS) Instructions.
Report the units of service to be provided with ALL funding sources. Related funding is reported in the annual Area Plan Budget (CDA 122) for Titles IIIB, IIIC-1, IIIC-2, IIID, and VIIA.
1. Personal Care (In-Home) Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
2. Homemaker (In-Home) Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 5,400 2
2017-2018
2018-2019
2019-2020
APPROVED
49
3. Chore (In-Home) Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
4. Home-Delivered Meal Unit of Service = 1 meal
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 140,000 1
2017-2018
2018-2019
2019-2020
5. Adult Day/ Health Care (In-Home) Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
APPROVED
50
6. Case Management (Access) Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 960 2
2017-2018
2018-2019
2019-2020
7. Assisted Transportation (Access) Unit of Service = 1 one-way trip
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
8. Congregate Meals Unit of Service = 1 meal
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 50,000 1
2017-2018
2018-2019
2019-2020
APPROVED
51
9. Nutrition Counseling Unit of Service = 1 session per participant
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
10. Transportation (Access) Unit of Service = 1 one-way trip
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017
2017-2018
2018-2019
2019-2020
11. Legal Assistance Unit of Service = 1 hour
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 1,600 1
2017-2018
2018-2019
2019-2020
APPROVED
52
12. Nutrition Education Unit of Service = 1 session per participant
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 4,000 1
2017-2018
2018-2019
2019-2020
13. Information and Assistance (Access) Unit of Service = 1 contact
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 2,000 1 1.3, 1.8
2017-2018
2018-2019
2019-2020
14. Outreach (Access) Unit of Service = 1 contact
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers (if applicable)
2016-2017 500 1 1.1, 1.3, 1.5, 1.8
2017-2018
2018-2019
2019-2020
APPROVED
53
15. NAPIS Service Category – “Other” Title III Services
Other Supportive Service Category Cash/Material Aid Unit of Service = 1 instance
Fiscal Year Proposed
Units of Service Goal Numbers Objective Numbers
2016-2017 10 1
2017-2018
2018-2019
2019-2020
16. Title IIID/ Disease Prevention and Health Promotion
Instructions for Title IIID Disease Prevention and Health Promotion: Enter the proposed units of service and the Program Goal and Objective number(s) that provides a narrative description of the program and explains how the service activity meets the criteria for evidence-based programs described in PM 15-10.
Unit of Service = 1 contact
Service Activities: A Matter of Balance Classes
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers
(Required)
2016-2017 48 2 2.2
2017-2018
2018-2019
2019-2020
APPROVED
54
Unit of Service = 1 contact
Service Activities: Tai Chi: Moving for Better Balance
Fiscal Year Proposed
Units of Service
Goal Numbers Objective Numbers
(Required)
2016-2017 30 2 2.2
2017-2018
2018-2019
2019-2020
APPROVED
55
PSA 30
TITLE IIIB and Title VIIA:
LONG-TERM CARE (LTC) OMBUDSMAN PROGRAM OUTCOMES 2016–2020 Four-Year Planning Cycle
Outcome 1. The problems and concerns of long-term care residents are solved through complaint resolution and other services of the Ombudsman Program. [OAA Section 712(a)(3),(5)]
Measures and Targets:
A. Complaint Resolution Rate (AoA Report, Part I.E, Actions on Complaints)
The average California complaint resolution rate for FY 2013-2014 was 73%.
1. FY 2014-2015 Baseline Resolution Rate:
Number of complaints resolved 294 + Number of partially resolved complaints 87 divided by the Total Number of Complaints Received 679 = Baseline Resolution Rate 56%
FY 2016-17 Target Resolution Rate 65%
2. FY 2015-2016 Baseline Resolution Rate:
Number of complaints resolved + Number of partially resolved complaints divided by the Total Number of Complaints Received = Baseline Resolution Rate %
FY 2017-18 Target Resolution Rate %
3. FY 2016-2017 Baseline Resolution Rate:
Number of complaints resolved + Number of partially resolved complaints divided by the Total Number of Complaints Received = Baseline Resolution Rate %
FY 2018-19 Target Resolution Rate %
4. FY 2017-2018 Baseline Resolution Rate:
Number of complaints resolved + Number of partially resolved complaints divided by the Total Number of Complaints Received = Baseline Resolution Rate %
FY 2019-20 Target Resolution Rate %
Program Goals and Objective Numbers: Goal 2
APPROVED
56
B. Work with Resident Councils (AoA Report, Part III.D.8)
1. FY 2014-2015 Baseline: number of Resident Council meetings attended 52 FY 2016-2017 Target: 55
2. FY 2015-2016 Baseline: number of Resident Council meetings attended
FY 2017-2018 Target:
3. FY 2016-2017 Baseline: number of Resident Council meetings attended
FY 2018-2019 Target:
4. FY 2017-2018 Baseline: number of Resident Council meetings attended
FY 2019-2020 Target:
Program Goals and Objective Numbers: Goal 2
C. Work with Family Councils (AoA Report, Part III.D.9)
1. FY 2014-2015 Baseline number of Family Council meetings attended 5
FY 2016-2017 Target: 5
2. FY 2015-2016 Baseline number of Family Council meetings attended
FY 2017-2018 Target:
3. FY 2016-2017 Baseline number of Family Council meetings attended
FY 2018-2019 Target:
4. FY 2017-2018 Baseline number of Family Council meetings attended
FY 2019-2020 Target:
Program Goals and Objective Numbers: Goal 2
D. Consultation to Facilities (AoA Report, Part III.D.4) Count of instances of ombudsman representatives’ interactions with facility staff for the purpose of providing general information and assistance unrelated to a complaint. Consultation may be accomplished by telephone, letter, email, fax, or in person.
1. FY 2014-2015 Baseline: number of consultations 200
FY 2016-2017 Target: 205
2. FY 2015-2016 Baseline: number of consultations
FY 2017-2018 Target:
3. FY 2016-2017 Baseline: number of consultations
APPROVED
57
FY 2018-2019 Target:
4. FY 2017-2018 Baseline: number of consultations
FY 2019-2020 Target:
Program Goals and Objective Numbers: Goal 2
E. Information and Consultation to Individuals (AoA Report, Part III.D.5) Count of instances of ombudsman representatives’ interactions with residents, family members, friends, and others in the community for the purpose of providing general information and assistance unrelated to a complaint. Consultation may be accomplished by: telephone, letter, email, fax, or in person.
1. FY 2014-2015 Baseline: number of consultations 697
FY 2016-2017 Target: 700
2. FY 2015-2016 Baseline: number of consultations
FY 2017-2018 Target:
3. FY 2016-2017 Baseline: number of consultations
FY 2018-2019 Target:
4. FY 2017-2018 Baseline: number of consultations
FY 2019-2020 Target:
Program Goals and Objective Numbers: Goal 2
F. Community Education (AoA Report, Part III.D.10) LTC Ombudsman Program participation in public events planned to provide information or instruction to community members about the LTC Ombudsman Program or LTC issues. The number of sessions refers to the number of events, not the number of participants.
1. FY 2014-2015 Baseline: number of sessions 16
FY 2016-2017 Target: 20
2. FY 2015-2016 Baseline: number of sessions
FY 2017-2018 Target:
3. FY 2016-2017 Baseline: number of sessions
FY 2018-2019 Target:
1. FY 2017-2018 Baseline: number of sessions FY 2019-2020 Target:
APPROVED
58
Program Goals and Objective Numbers: Objective 2.11
G. Systems Advocacy
Enter information in the box below.
Systemic Advocacy Effort(s) for the current fiscal year 2016-2017:
The staff of the Ombudsman Program in Stanislaus County will work with the staff in the
office of the Mother Lode Ombudsman Program to develop Emergency Preparedness plans to
use in the facilities with both programs. The plans will assist the facility staff to make the
necessary changes to be able to meet the needs of residents during an emergency.
Outcome 2. Residents have regular access to an Ombudsman. [(OAA Section 712(a)(3)(D), (5)(B)(ii)]
Measures and Targets:
A. Facility Coverage (other than in response to a complaint), (AoA Report, Part III.D.6)
Percentage of nursing facilities within the PSA that were visited by an ombudsman representative at least once each quarter not in response to a complaint. The percentage is determined by dividing the number of nursing facilities in the PSA that were visited at least once each quarter not in response to a complaint by the total number of nursing facilities in the PSA. NOTE: This is not a count of visits but a count of facilities. In determining the number of facilities visited for this measure, no nursing facility can be counted more than once.
1. FY 2014-2015 Baseline: Number of Nursing Facilities visited at least once a quarter not in response to a complaint 19 divided by the total number of Nursing Facilities 20 = Baseline 95%
FY 2016-2017 Target: 95%
2. FY 2015-2016 Baseline: Number of Nursing Facilities visited at least once a quarter not in response to a complaint divided by the total number of Nursing Facilities = Baseline %
FY 2017-2018 Target: %
3. FY 2016-2017 Baseline: Number of Nursing Facilities visited at least once a quarter not in response to a complaint divided by the total number of Nursing Facilities = Baseline %
FY 2018-2019 Target: %
4. FY 2017-2018 Baseline: Number of Nursing Facilities visited at least once a quarter not in response to a complaint divided by the total number of Nursing Facilities = Baseline
APPROVED
59
%
FY 2019-2020 Target: %
Program Goals and Objective Numbers: Goal 2
B. Facility Coverage (other than in response to a complaint) (AoA Report, Part III.D.6)
Percentage of RCFEs within the PSA that were visited by an ombudsman representative at least once each quarter during the fiscal year not in response to a complaint. The percentage is determined by dividing the number of RCFEs in the PSA that were visited at least once each quarter not in response to a complaint by the total number of RCFEs in the PSA.
NOTE: This is not a count of visits but a count of facilities. In determining the number of facilities visited for this measure, no RCFE can be counted more than once.
1. FY 2014-2015 Baseline: Number of RCFEs visited at least once a quarter not in response to a complaint 54 divided by the total number of RCFEs 85 = Baseline 64%
FY 2016-2017 Target: 70% 2. FY 2015-2016 Baseline: Number of RCFEs visited at least once a quarter not in
response to a complaint divided by the total number of RCFEs = Baseline %
FY 2017-2018 Target: % 3. FY 2016-2017 Baseline: Number of RCFEs visited at least once a quarter not in
response to a complaint divided by the total number of RCFEs = Baseline %
FY 2018-2019 Target: %
4. FY 2017-2018 Baseline: Number of RCFEs visited at least once a quarter not in response to a complaint divided by the total number of RCFEs = Baseline %
FY 2019-2020 Target: % Program Goals and Objective Numbers: Goal 2
C. Number of Full-Time Equivalent (FTE) Staff (AoA Report Part III. B.2. - Staff and Volunteers)
This number may only include staff time legitimately charged to the LTC Ombudsman Program. Time spent working for or in other programs may not be included in this number. For example, in a local LTC Ombudsman Program that considers full-time employment to be 40 hour per week, the FTE for a staff member who works in the Ombudsman Program 20 hours a week should be 0.5, even if the staff member works an additional 20 hours in another program.
1. FY 2014-2015 Baseline: 1.38 FTEs
FY 2016-2017 Target: 1.5 FTEs
APPROVED
60
2. FY 2015-2016 Baseline: FTEs
FY 2017-2018 Target: FTEs
3. FY 2010-2011 Baseline: FTEs
FY 2013-2014 Target: FTEs
4. FY 2010-2011 Baseline: FTEs
FY 2014-2015 Target: FTEs
Program Goals and Objective Numbers: Goal 2
D. Number of Certified LTC Ombudsman Volunteers (AoA Report Part III. B.2. – Staff and Volunteers)
1. FY 2014-2015 Baseline: Number of certified LTC Ombudsman volunteers 20 FY 2016-2017 Projected Number of certified LTC Ombudsman volunteers 20
2. FY 2015-2016 Baseline: Number of certified LTC Ombudsman volunteers FY 2017-2018 Projected Number of certified LTC Ombudsman volunteers
3. FY 2016-2017 Baseline: Number of certified LTC Ombudsman volunteers
FY 2018-2019 Projected Number of certified LTC Ombudsman volunteers
4. FY 2017-2018 Baseline: Number of certified LTC Ombudsman volunteers FY 2019-2020 Projected Number of certified LTC Ombudsman volunteers
Program Goals and Objective Numbers: Goal 2
APPROVED
61
Outcome 3. Ombudsman representatives accurately and consistently report data about their complaints and other program activities in a timely manner. [OAA Section 712(c)]
Measures and Targets:
In the box below, in narrative format, describe one or more specific efforts your program will undertake in the upcoming year to increase the accuracy, consistency, and timeliness of your National Ombudsman Resource System (NORS) data reporting.
1. Coordinate with the SLTCO office to request that our analyst come onsite or via a conference call for ODIN Training.
2. Participate in the on-going NORS training.
3. Review individual Ombudsman cases and identify systemic issues, or in possible area that the Ombudsman can improve or correct.
4. Track and identify cases that are not being completed in a timely manner and work with Ombudsmen to close them out.
5. Include ODIN as a topic in the monthly Ombudsman CEU meeting agenda for questions, suggestions or tips.
6. Purchase two Ombudsman laptops that will be checked out by the Ombudsman that do not have a computer.
APPROVED
62
TITLE VIIA ELDER ABUSE PREVENTION
SERVICE UNIT PLAN OBJECTIVES
PSA 30
TITLE VIIA ELDER ABUSE PREVENTION SERVICE UNIT PLAN OBJECTIVES The agency receiving Title VIIA Elder Abuse Prevention funding is: Catholic Charities, Diocese of Stockton
Fiscal Year Total # of Public Education Sessions
Fiscal Year Total # of Training Sessions for Professionals
2016-2017 5 2016-2017 5
2017-2018 2017-2018
2018-2019 2018-2019
2019-2020 2019-2020
Fiscal Year
Total # of Training Sessions for
Caregivers served by Title IIIE
Fiscal Year Total # of Hours Spent
Developing a Coordinated System
2016-2017 0 2016-2017 100
2017-2018 2017-2018
2018-2019 2018-2019
2019-2020 2019-2020
Fiscal Year Total # of Copies of
Educational Materials to be Distributed
Description of Educational Materials
2016-2017 1500
1. Bank teller training materials to assist them in identifying fraud and abuse and how to report suspected financial abuse – i.e. Mandated Reporter Flow Chart, Elder Financial Abuse fact sheet – CANHR, Recognizing and Report Elder Abuse -CANHR
APPROVED
63
2. Packet of information to distribute to agency in-home assistants on how to identify abuse and how to report it – i.e. Stanislaus Scam Line (Door hanger flyers)- Senior Law office and Resident Right Fact Sheet - CANHR
3. Updated informational brochures for distribution at senior centers and other community venues – Senior information line brochures, Ombudsman Brochures.
2017-2018
2018-2019
2019-2020
Fiscal Year Total Number of Individuals Served
2016-2017 500
2017-2018
2018-2019
2019-2020
APPROVED
64
PSA 30
TITLE IIIE SERVICE UNIT PLAN OBJECTIVES
CCR Article 3, Section 7300(d)
2012–2016 Four-Year Planning Period
This Service Unit Plan (SUP) uses the five broad federally-mandated service categories defined in PM 11-11. Refer to the CDA Service Categories and Data Dictionary Revisions Effective July 1, 2011 for eligible activities and service unit measures. Specify proposed audience size or units of service for ALL budgeted funds.
Direct and/or Contracted IIIE Services
CATEGORIES
1
2
3
Family Caregiver Services
Caring for Elderly
Proposed
Units of Service
Required
Goal #(s)
Optional
Objective #(s)
Information Services # of activities and
Total est. audience for above
2016-2017 # of activities: 100
Total est. audience for above: 25,000
1
2017-2018 # of activities:
Total est. audience for above:
2018-2019 # of activities:
Total est. audience for above:
2019-2020 # of activities:
Total est. audience for above:
APPROVED
65
Access Assistance Total contacts
2016-2017 450 1
2017-2018
2018-2019
2019-2020
Support Services Total hours
2016-2017 275 1
2017-2018
2018-2019
2019-2020
Respite Care Total hours
2016-2017 2,500 1
2017-2018
2018-2019
2019-2020
Supplemental Services Total occurrences
2016-2017 100 1
2017-2018
2018-2019
2019-2020
APPROVED
66
Direct and/or Contracted IIIE Services
Grandparent Services
Caring for Children
Proposed
Units of Service
Required
Goal #(s)
Optional
Objective #(s)
Information Services # of activities and
Total est. audience for above
2016-2017 # of activities:
Total est. audience for above:
2017-2018 # of activities:
Total est. audience for above:
2018-2019 # of activities:
Total est. audience for above:
2019-2020 # of activities:
Total est. audience for above:
Grandparent Services
Caring for Children
Proposed
Units of Service
Required
Goal #(s)
Optional
Objective #(s)
Access Assistance Total contacts
2016-2017
2017-2018
2018-2019
2019-2020
Support Services Total hours
2016-2017
2017-2018
2018-2019
APPROVED
67
2019-2020
Respite Care Total hours
2016-2017
2017-2018
2018-2019
2019-2020
Supplemental Services Total occurrences
2016-2017
2017-2018
2018-2019
2019-2020
APPROVED
68
PSA 30
SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
List all SCSEP monitor sites (contract or direct) where the AAA
provides SCSEP enrollment services within the PSA (Do not list host agencies)
Enrollment Location/Name (AAA office, One Stop, Agency, etc.): SER-Jobs for Progress, EDD Office
Street Address: 629 12th St, Modesto, CA 95354
Name and title of all SCSEP paid project staff members (Do not list participant or participant staff names): Frances Trujillo, Project Coordinator
Dolores Brunson, Assistant Case Manager
Number of paid staff: 2 Number of participant staff: 0
How many participants are served at this site? 15
APPROVED
69
PSA 30
HEALTH INSURANCE COUNSELING AND ADVOCACY PROGRAM (HICAP)
SERVICE UNIT PLAN
CCR Article 3, Section 7300(d)
STATE & FEDERAL PERFORMANCE TARGETS: In FY 2014, the State Health Insurance Assistance Program (SHIP) was transferred from the Centers for Medicare & Medicaid Services (CMS) to the Administration for Community Living (ACL). ACL has continued CMS’ policy requiring all SHIPs to meet established performance measures. Based on ACL guidelines and to assist AAAs in completing the Service Unit Plan, CDA provides State (1.1 and 1.2), and federal (2.1 through 2.7) performance measures (PM) annually. To download these measures and view definitions, visit https://www.aging.ca.gov/ProgramsProviders/AAA/Planning/
Section 1. State Performance Measures
All sections will be completed following the receipt of numbers from the State HICAP office.
Fiscal Year
(FY) PM 1.1 Clients
Counseled (Estimated) Goal Numbers
2016-2017 922 1.4
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
PM 1.2 Public and Media Events (PAM) (Estimated)
Goal Numbers
2016-2017 36 1.10
2017-2018
2018-2019
2019-2020
APPROVED
70
Section 2: Federal Performance Measures
Fiscal Year
(FY)
PM 2.2 Persons Reached at PAM Events
(Estimated)
Goal Numbers
2016-2017 3,862 1.10
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
PM 2.3 Contacts with Medicare Beneficiaries
Due to Disability (Estimated)
Goal Numbers
2016-2017 669 1
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY) PM 2.1 Total Client
Contacts (Estimated) Goal Numbers
2016-2017 3,509 1
2017-2018
2018-2019
2019-2020
APPROVED
71
Fiscal Year
(FY)
PM 2.4 Low-income Medicare Beneficiary Contacts (Estimated)
Goal Numbers
2016-2017 2,394 1
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
PM 2.5 Contacts with One or More Qualifying
Enrollment Topics (Estimated)
Goal Numbers
2016-2017 3,286 1
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
PM 2.6 Total Part D Enrollment/Assistance Contacts (Estimated)
Goal Numbers
2016-2017 2,151 1
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY) PM 2.7 Total Counseling
Hours (Estimated) Goal Numbers
2016-2017 2,069 1
2017-2018
2018-2019
2019-2020
APPROVED
72
Section 3: HICAP Legal Services Units of Service (if applicable)
Fiscal Year
(FY)
3.1 Estimated Number of Clients Represented Per
FY (Unit of Service) Goal Numbers
2016-2017 N/A
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
3.2 Estimated Number of Legal Representation Hours Per FY (Unit of
Service)
Goal Numbers
2016-2017 N/A
2017-2018
2018-2019
2019-2020
Fiscal Year
(FY)
3.3 Estimated Number of Program Consultation Hours Per FY (Unit of
Service)
Goal Numbers
2016-2017 N/A
2017-2018
2018-2019
2019-2020 APPROVED
73
SECTION 11 - FOCAL POINTS PSA 30
COMMUNITY FOCAL POINTS LIST
CCR Title 22, Article 3, Section 7302(a)(14), 45 CFR Section 1321.53(c), OAA 2006 306(a)
In the form below, provide the current list of designated community focal points and their addresses. This information must match the total number of focal points reported in the National Aging Program Information System (NAPIS) State Program Report (SPR), i.e., California Aging Reporting System, NAPISCare, Section III.D.
Designated Community Focal Point Address
Modesto Senior Center 211 Bodem St, Modesto, CA 95350
Gladys Lemmons Senior Center 450 East A St, Oakdale, CA 95361
Hammon Senior Center 1033 West Las Palmas Ave, Patterson, CA 95363
Mancini Hall Tuolumne Blvd, Modesto, CA 95354
The Turlock Corps of The Salvation Army 893 Lander Ave, Turlock, CA 95380
APPROVED
74
SECTION 12 - DISASTER PREPAREDNESS PSA 30
Disaster Preparation Planning Conducted for the 2016-2020 Planning Cycle OAA Title III, Sec. 306(a)(17); 310, CCR Title 22, Sections 7529 (a)(4) and 7547, W&I Code Division 8.5, Sections 9625 and 9716, CDA Standard Agreement, Exhibit E, Article 1, 22-25, Program Memo 10-29(P)
1. Describe how the AAA coordinates its disaster preparedness plans and activities with
local emergency response agencies, relief organizations, state and local governments, and other organizations responsible for emergency preparedness and response as required in OAA, Title III, Section 310:
The Stanislaus County administration and Board of Supervisors govern the Department of Aging and
Veterans Services. During and after a disaster the staff of the department will be part of a countywide
effort to respond to emergency needs for all citizens. The staff of the department will be contacted by
the staff of the Office of Emergency Services (OES) and directed as to how they may assist the efforts
that will be coordinated by the OES.
The mission of the Stanislaus County Area Agency on Aging (AAA) in response to a disaster is to
provide accurate information about services available to senior citizens, persons with disabilities, and
their caregivers; ensure referral to those services; and to assist in the full recovery from a disaster. An
integral part of this plan is to coordinate information and services with the Stanislaus County
Community Services Agency Adult Services Division to avoid duplication of services. All information
and services will be coordinated with the Stanislaus County Office of Emergency Services.
Assistance following a disaster includes:
a. Connecting senior citizens with agencies that can help maintain optimal health.
b. Help to restore the former living conditions, when possible.
The staff of the Department of Aging and Veterans Services has complied with County regulations in
drafting a Continuity of Operations Plan (COOP). This plan outlines how staff will handle the various
parts of their jobs following an event that could interrupt the normal operations. It includes information
about the physical needs of staff, as well as the means to handle the interruption of tasks.
APPROVED
75
2. Identify each of the local Office of Emergency Services (OES) contact person(s) within the PSA that the AAA will coordinate with in the event of a disaster (add additional information as needed for each OES within the PSA):
Name Title Telephone email
Dale Skiles Fire Warden Office: 209-552-3600 Cell:
3. Identify the Disaster Response Coordinator within the AAA:
Name Title Telephone email
Linda Lowe Planner Office: 209-525-4612 Cell: 209-604-5982
4. List critical services the AAA will continue to provide after a disaster and describe how
these services will be delivered:
Critical Services How Delivered?
a Information and Assistance b Meals c MSSP d Post-disaster follow-up
a Resources at the AAA office or remotely, using access through the County message system b Assist the provider of senior meals with delivery of meals to homes and sites c Assist social workers to contact potentially affected seniors d Contact seniors within affected area, using County and AAA database, offer information and potential assistance
5. List any agencies with which the AAA has formal emergency preparation or response
agreements.
As a county department the AAA staff acts under the direction of the Office of Emergency Services
(OES). As such the Department of Aging and Veterans Services is dependent upon the OES to maintain
agreements with the American Red Cross, FEMA, and state agencies. Each of the AAA provider
agencies must submit, as part of their contract, their disaster plans.
6. Describe how the AAA will:
• Identify vulnerable populations.
APPROVED
76
The AAA staff will use the databases that include MSSP and home-delivered meals clients. We
will coordinate with the county In Home Supportive Services Department to offer assistance
contacting and assisting their clients.
Stanislaus County OES will be implementing a new system, Everbridge, a system that has the
capacity to contact persons and groups identified by each department. A feature of the new
system is for consumers to allow communication in case of emergency, via land line, mobile
phone, and computer. The AAA will be offering this service to participants in AAA programs to
efficiently contact affected persons.
The AAA staff will work with the Latino Community Roundtable, a non-profit group who has
agreed to assist in contacting citizens in the Hispanic population, especially Hispanic seniors, in
case of emergencies.
• Follow-up with these vulnerable populations after a disaster event.
We will seek to contact these clients via telephone, if applicable, or by visit to their home or
shelter.
We will offer assistance in completion of forms, referrals for appropriate repairs to homes, or
reparation, depending upon the nature of the disaster and the availability of appropriate
alternatives, such as housing.
APPROVED
77
SECTION 13 - PRIORITY SERVICES PSA 30
2016-2020 Four-Year Planning Cycle
Funding for Access, In-Home Services, and Legal Assistance
The CCR, Article 3, Section 7312, requires the AAA to allocate an “adequate proportion” of federal funds to provide Access, In-Home Services, and Legal Assistance in the PSA. The annual minimum allocation is determined by the AAA through the planning process. The minimum percentages of applicable Title III B funds10 listed below have been identified for annual expenditure throughout the four-year planning period. These percentages are based on needs assessment findings, resources available within the PSA, and discussions at public hearings on the Area Plan.
Category of Service and the Percentage of Title III B Funds expended in/or to be expended in FY 2016-17 through FY 2019-20
Access: Transportation, Assisted Transportation, Case Management, Information and Assistance, Outreach, Comprehensive Assessment, Health, Mental Health, and Public Information
2016-17 33.04% 17-18 % 18-19 % 19-20 %
In-Home Services:
Personal Care, Homemaker, Chore, Adult Day / Health Care, Alzheimer’s, Residential Repairs/Modifications, Respite Care, Telephone Reassurance, and Visiting
2016-17 20.47% 17-18 % 18-19 % 19-20 %
Legal Assistance Required Activities:11
Legal Advice, Representation, Assistance to the Ombudsman Program and Involvement in the Private Bar
2016-17 22.02% 17-18 % 18-19 % 19-20 %
Explain how allocations are justified and how they are determined to be sufficient to meet the need for the service within the PSA.
10 Minimum percentages of applicable funds are calculated on the annual Title IIIB baseline allocation, minus Title IIIB administration and
minus Ombudsman. At least one percent of the final Title IIIB calculation must be allocated for each “Priority Service” category or a waiver must be requested for the Priority Service category(s) that the AAA does not intend to fund.
11 Legal Assistance must include all of the following activities: Legal Advice, Representation, Assistance to the Ombudsman Program and Involvement in the Private Bar.
APPROVED
78
For Access Services:
Responses from the recent Needs Assessment Survey showed a significant need to inform the
public, and senior citizens in particular, about the varied services available through the AAA and other
agencies. Approximately 45% of respondents believed that getting information about senior services was
either a minor, serious or very serious problem. Following getting information were issues of actually
receiving those benefits. 42% of respondents believed it was a problem to receive benefits. The AAA
staff needs to find other ways to convey to the public about available services. For a number of years,
since the Linkages Program funds were removed from the state budget, the Information office at the
AAA has received inquiries from seniors who did not qualify for MSSP or other case management
programs. During the current year referrals to the Case Management Program have illustrated the need
for this service to continue in the coming years.
For In-Home Services:
Approximately 47% of respondents indicated that they had some degree of difficulty doing light
housework. Doing heavy housework was difficult for almost twice that number of respondents (74%).
Homemaker services will continue to be the focus for services in this category. The I&A staff frequently
receives requests for assistance with various kinds of housework from seniors, persons with disabilities
and caregivers. The staff has been able to refer consumers to community services that assist them find
help that goes beyond light housework. The AAA staff will continue to foster community involvement
with the needs of seniors.
Legal Assistance:
Of the respondents to the survey, 34% stated they believed that getting legal assistance could be a
problem. The contractor for the Senior Law Project has maintained a Memorandum of Understanding
with the contractor for the Ombudsman Program, as required. The contractor also has a contract with the
Adult Protective Services Department, primarily executing restraining orders. There is no shortage of
opportunities for the Senior Law Project staff to assist seniors, but a significant number of respondents
need to know about these services.
The focus groups that have been conducted prove these responses to be accurate in the ways that
the AAA staff can best use the scarce funds available to them. Since the amount of funding hasn’t
changed, the ways that the Title III B funds are allocated will remain at the current level in fiscal year
2016-2017.
APPROVED
79
SECTION 14 - NOTICE OF INTENT TO PROVIDE DIRECT SERVICES PSA 30
CCR Article 3, Section 7320 (a)(b) and 42 USC Section 3027(a)(8)(C)
If an AAA plans to directly provide any of the following services, it is required to provide a description of the methods that will be used to assure that target populations throughout the PSA will be served.
Check if not providing any of the below listed direct services.
Check applicable direct services Check each applicable Fiscal Year
Title IIIB 16-17 17-18 18-19 19-20
X Information and Assistance X X X X
X Case Management X X X X
X Outreach X X X X
X Program Development X X X X
X Coordination X X X X
Long-Term Care Ombudsman
Title IIID 16-17 17-18 18-19 19-20
Disease Prevention and Health Promo.
Title IIIE 12 16-17 17-18 18-19 19-20
X Information Services X X X X
X Access Assistance X X X X
X Support Services X X X X
Title VIIA 16-17 17-18 18-19 19-20
Long-Term Care Ombudsman
Title VII 16-17 17-18 18-19 19-20
Prevention of Elder Abuse, Neglect
and Exploitation
Describe methods to be used to ensure target populations will be served throughout the PSA.
The staff of the AAA produces and distributes a flyer in English (pink) and Spanish (blue) that lists names
and phone numbers of agencies and services that are available throughout Stanislaus County. The AAA direct line
and the 1-800-510-2020 numbers are listed prominently on the front of the flyer. These flyers are distributed at all
12 Refer to PM 11-11 for definitions of Title III E categories.
APPROVED
80
outreach events, through the service providers, at doctor offices, churches, city and county offices. The “pinks” and
“blues” are well-known to many people, due to the efforts of staff and volunteers who recognize that using this
resource to either contact our office or the numbers listed will result in positive connections in Stanislaus County.
These flyers are updated 2-3 times during the year to maintain the most current and accurate information is being
conveyed to the general public. The main AAA staff person responsible for Information and Assistance is
bilingual, English and Spanish. She continues to be a valuable resource for consumers and caregivers throughout
the county. As noted in several other areas, the AAA staff and volunteers need to find more creative ways to
distribute these flyers, as well as information about other services.
The AAA staff attends a number of senior-specific outreach events each year. These include those
sponsored by the Stanislaus Elder Abuse Prevention Alliance (SEAPA) in each of the cities in the county; health
information events sponsored by various agencies; the annual Healthy Aging and Fall Prevention Summit; and
community events, particularly in under-served small communities. Presentations to groups such as classes at the
Modesto Junior College, and service clubs in each community serve to give information to groups that interact
with members of the target populations in ways that the AAA staff would not usually meet. Maintaining the
Outreach Program as a direct service allows the AAA staff to give complete and accurate information to the
general public and to specific target populations. An area where the AAA staff expects to increase our presence is
through the efforts of the Director of Volunteer Services. As the staff seeks to increase volunteer involvement,
general information will be distributed, increasing the presence of the AAA in the multiple communities in the
County.
The AAA staff will use Program Development and Coordination funding to partner with agencies beyond
the current service providers as well as to assist our providers to enhance and improve their programs. For the
coming years these will include reaching out to seniors that are having difficulties with meeting expenses; those
that may become isolated due to various circumstances; those who are culturally or geographically challenged;
those who are victims of abuse; or those seniors that need
some assistance maintaining their independence. The staff has sought ways to work with other non-profit and
government agencies that will allow the staff and volunteers the opportunity to continue various services.
APPROVED
81
The Family Caregiver Support Program (FCSP) has been a direct service of the AAA since FY 2003-2004.
Referrals for this service have come naturally from the I&A Program and through agencies such as the Community
Hospice and Adult Protective Services. The AAA staff members that are bi-lingual, English/Spanish, have been
able to effectively assess and address the needs of caregivers whose principle language is Spanish. The AAA staff
regularly meets with caregivers in the various cities, towns and rural areas throughout the county to assess their
needs and determine how the AAA can assist them. Public Information and Community Education opportunities
are available in rural and urban communities. Included in these opportunities are presentations to college students,
attendance at health fairs, and participation in educational workshops specifically aimed at caregivers. The AAA
staff has co-sponsored a number of events organized by the Northern California and Northern Nevada Chapter of
the Alzheimer’s Association, providing information and support for caregivers of Alzheimer’s disease patients.
The workshops have been held in Modesto, Oakdale, Turlock, and Hughson, representing rural and urban settings.
The AAA staff chaired the committee from the Senior Coalition to produce a booklet, Caregiver Information,
Services and Resources in Stanislaus County, and maintains an up to date version on the www.agingservices.info
website. Hard copies are printed twice per year to distribute at outreach events, and for each caregiver that is
assessed for participation in the Family Caregiver Support Program. As workshop opportunities and potentially
helpful information is available via the internet, the AAA staff notifies caregivers via a private list-serve.
Notification is sent to any caregiver who requests participation, being assured that their address and other private
information is never shared. Two-three notifications per month, on average, are sent to over 100 caregivers.
APPROVED
82
SECTION 15 - REQUEST FOR APPROVAL TO PROVIDE DIRECT SERVICES PSA 30
Older Americans Act, Section 307(a)(8)
CCR Article 3, Section 7320(c), W&I Code Section 9533(f)
Complete and submit for CDA approval a separate Section 15 for each direct service not specified in Section 14. The request for approval may include multiple funding sources for a specific service.
Check box if not requesting approval to provide any direct services.
Identify Service Category: HICAP Check applicable funding source:
IIIB
IIIC-1
IIIC-2
Nutrition Education
IIIE
VIIA X HICAP
Request for Approval Justification:
X Necessary to Assure an Adequate Supply of Service OR
More cost effective if provided by the AAA than if purchased from a comparable service provider.
Check all fiscal year(s) the AAA intends to provide service during this Area Plan cycle.
X 2016-17 X 2017-18 X 2018-19 X 2019-20
Justification: Provide a cost-benefit analysis below that substantiates this request for direct delivery of the above stated service :
The HICAP program has been part of the AAA direct services since FY 2006-07 and the HICAP
staff have been able to access county resources such as the fiscal and administrative staff already located
in the AAA office. The staff includes 2.8 FTE positions, 7 certified volunteer counselors, and 1 AAA
staff person trained to handle general information and appointments. This arrangement assists the HICAP
APPROVED
83
staff and volunteers, combining AAA and HICAP resources to reach out to potential consumers and
volunteers. The staff and volunteers include persons who are bilingual, English and Spanish.
The AAA staff members trained to answer basic questions include the Information & Assistance
(I&A) staff. The I&A staff have been able to assist the HICAP staff and volunteers arrange for
appointments, and get preliminary information from clients, streamlining the appointment times. In
addition, HICAP staff and volunteers assist the other AAA staff at outreach events, distributing
information for all AAA programs. The current HICAP Manager began her career with the AAA in other
capacities and consequently is able to assist with programs such as the Family Caregiver Support
Program and I&A.
During the last several years the AAA and HICAP staffs have established counseling
appointments one day each month in cities away from the Modesto office. Either a staff member or a
volunteer meets consumers in Turlock, Oakdale and Patterson. This gives the counselors the opportunity
to reach people who might not drive to Modesto thus addressing the needs of seniors that are
geographically isolated. For consumers for whom the primary language is Spanish, a bilingual staff
member conducts the appointment. These days have been arranged with the assistance of AAA staff and
the staffs of the senior centers in those cities.
Collaboration between the divisions within the Department of Aging and Veterans Services
continues to benefit from the presence of the HICAP staff and volunteers as one part of our department.
In-person referrals and questions are easily handled, more effectively benefitting the consumer than
would be available should the HICAP be contracted to a different agency. Consumers receive services
more easily and completely due to the ease of making contacts throughout the department. APPROVED
84
SECTION 15 - REQUEST FOR APPROVAL TO PROVIDE DIRECT SERVICES PSA 30
Older Americans Act, Section 307(a)(8)
CCR Article 3, Section 7320(c), W&I Code Section 9533(f) Complete and submit for CDA approval a separate Section 15 for each direct service not specified in Section 14. The request for approval may include multiple funding sources for a specific service.
Check box if not requesting approval to provide any direct services. Identify Service Category: Cash/Material Aid Check applicable funding source: X IIIB
IIIC-1
IIIC-2
Nutrition Education
IIIE
VIIA
HICAP Request for Approval Justification: X Necessary to Assure an Adequate Supply of Service OR
More cost effective if provided by the AAA than if purchased from a comparable service provider.
Check all fiscal year(s) the AAA intends to provide service during this Area Plan cycle.
X 2016-17 X 2017-18 X 2018-19 X 2019-20 Justification: Provide a cost-benefit analysis below that substantiates this request for direct delivery of the above stated service:
Due to a number of factors, many seniors are having difficulty meeting basic needs. The
Information and Assistance Program receives requests for assistance with utility bills, emergency rent
APPROVED
85
help, or other immediate needs. Contact with the AAA staff is a natural and readily accessible resource
for many kinds of assistance. In many cases it has become preferable for agency staff and consumers to
contact the AAA than to contact other agencies that appear to serve limited populations. Referrals for
immediate assistance come from home health agencies, healthcare organizations, government agencies,
and discharge planners from hospitals and re-habilitation facilities. Coordination among these sometimes
disparate agencies is key to meeting the needs of the consumers and the AAA staff is qualified to handle
that coordination as a neutral agency. The AAA staff will continue to partner with other agencies to meet
these needs, especially when a senior is in danger of potential abuse, has a utility shut-off notice, or other
immediate emergency. Partner agencies/departments include Adult Protective Services, Catholic
Charities, the Senior Advocacy Network/Senior Law Project, and the Howard Training Center.
The AAA staff that assesses and approves the use of these funds manages and oversees other
programs. In addition, the procedures used to handle the consumer’s needs include the involvement of
other AAA staff members. The cost for each of these staff can be spread over several programs, retaining
most of the funds to assist consumers. Procedures include assessing the need, determining possible
alternative funding sources, and determining the client’s ability to avoid future emergencies.
Cash/Material Aid will be used for immediate needs that cannot be met by other sources, or in
conjunction with funding from other sources. It will be used to help a client to maintain the safest
possible living situation, within their own abilities.
APPROVED
86
SECTION 15 - REQUEST FOR APPROVAL TO PROVIDE DIRECT SERVICES PSA 30
Older Americans Act, Section 307(a)(8)
CCR Article 3, Section 7320(c), W&I Code Section 9533(f) Complete and submit for CDA approval a separate Section 15 for each direct service not specified in Section 14. The request for approval may include multiple funding sources for a specific service.
Check box if not requesting approval to provide any direct services. Identify Service Category: Family Caregiver Support Program Respite Services Check applicable funding source:
IIIB
IIIC-1
IIIC-2
Nutrition Education X IIIE
VIIA
HICAP Request for Approval Justification: Necessary to Assure an Adequate Supply of Service OR X More cost effective if provided by the AAA than if purchased from a comparable service
provider. Check all fiscal year(s) the AAA intends to provide service during this Area Plan cycle.
X 2016-17 X 2017-18 X 2018-19 X 2019-20 Justification: Provide a cost-benefit analysis below that substantiates this request for direct delivery of the above stated service:
The Family Caregiver Support Program has been operated successfully through the AAA for 13
years. The AAA staff has developed and maintained professional relationships with local home health
APPROVED
87
agencies that have been available to supply respite services to hundreds of caregivers during that time.
Contracts with in-home agencies include requirements to provide respite to caregivers throughout the
county, including the rural and largely minority communities.
The nature of the services, respite for caregivers for emergency or occasional use, has been met
with relief by the caregivers, with the wish that more respite services could be supplied. When special
training opportunities or workshops have been available, the AAA staff has been able to allocate
additional respite services, due to funds that do not need to be spent on administrative or overhead
expenses. Staff that handles the assessments includes the I&A staff persons as well as AAA social
workers. The staff has been sensitive to additional needs that are evident during home visits, needs that
the AAA staff is uniquely qualified to meet. The staff has easily been able to access the resources within
the AAA, including the fiscal and administrative staff. The AAA staff is able to provide the
administrative duties that are required for the respite services, in addition to other duties, making the
provision of the respite services more cost effective for the AAA to provide this service. The AAA staff
is able to dedicate more funds for respite services due to the shared responsibilities within the
Department.
APPROVED
88
SECTION 15 - REQUEST FOR APPROVAL TO PROVIDE DIRECT SERVICES PSA 30
Older Americans Act, Section 307(a)(8)
CCR Article 3, Section 7320(c), W&I Code Section 9533(f) Complete and submit for CDA approval a separate Section 15 for each direct service not specified in Section 14. The request for approval may include multiple funding sources for a specific service.
Check box if not requesting approval to provide any direct services. Identify Service Category: Family Caregiver Support Program Supplemental Services Check applicable funding source:
IIIB
IIIC-1
IIIC-2
Nutrition Education X IIIE
VIIA
HICAP Request for Approval Justification: Necessary to Assure an Adequate Supply of Service OR X More cost effective if provided by the AAA than if purchased from a comparable service
provider. Check all fiscal year(s) the AAA intends to provide service during this Area Plan cycle.
X 2016-17 X 2017-18 X 2018-19 X 2019-20 Justification: Provide a cost-benefit analysis below that substantiates this request for direct delivery of the above stated service:
The AAA staff that handles caregiver assessment also determines the needs for assistive devices
and which ones would be most appropriate. Overhead costs to ensure the purchase of appropriate
APPROVED
89
devices are shared with the administrative costs that include all parts of the AAA, including the work of
the fiscal staff. There is no additional space or staff needed to accomplish this aspect of the Family
Caregiver Support Program.
For over 10 years the AAA staff has had a relationship with a non-profit organization that
includes retired persons who volunteer their time to assist caregivers with installation of assistive
devices. This organization is available to assist caregivers with cost-effective and reliable services, and
an attitude of dedication that isn’t necessarily evident with other contractor services. The AAA staff
purchases the appropriate devices and the volunteers accomplish the installation, with no labor cost to the
AAA or to the caregiver.
The Stanislaus Senior Foundation was formed to assist seniors remain independent and safe in
their homes, especially when they have emergency needs for which no other funding exists. Most often
the Foundation funds have been used to pay utility bills or purchase items that are necessary for seniors
to remain independent. Since many of the caregivers involved with the Family Caregiver Support
Program are spouses or the “senior” children of frail elders, their needs sometimes exceed the funding
available through the FCSP, making them eligible for assistance from the Foundation. The AAA staff
completes the initial assessment of the seniors referred to the Foundation for assistance and determines
the best solution for the emergency need. The availability of the funds from the Foundation gives the
AAA staff greater access to ways that they can assist caregivers and the frail elders they serve.
APPROVED
90
SECTION 16 - GOVERNING BOARD PSA 30
GOVERNING BOARD MEMBERSHIP
2016-2020 Four-Year Area Plan Cycle
CCR Article 3, Section 7302(a)(11)
Total Number of Board Members: 5
Name and Title of Officers: Office Term Expires:
Dick Montieth, Chair January 2019
William O’Brien, Vice-Chair January 2017
Names and Titles of All Members: Board Term Expires:
Vito Chiesa January 2017
Terrance Withrow January 2019
Jim DeMartini January 2017
APPROVED
91
SECTION 17 - ADVISORY COUNCIL PSA 30
ADVISORY COUNCIL MEMBERSHIP
2016-2020 Four-Year Planning Cycle
OAA 2006 306(a)(6)(D)
45 CFR, Section 1321.57
CCR Article 3, Section 7302(a)(12)
Total Council Membership (include vacancies) 21
Number of Council Members over age 60 19
% of PSA's % on 60+Population Advisory Council
Race/Ethnic Composition White 66% 80%
Hispanic 22.9% 10%
Black 2.3% 5%
Asian/Pacific Islander 5.3% 5%
Native American/Alaskan Native 0.9% 0
Other 3% 0
Name and Title of Officers: Office Term Expires:
Jeri Johnson, President June 30, 2016
Lillian Castigliano, 1st Vice President June 30, 2016
Joyce Gandelman, 2nd Vice President June 30, 2016
APPROVED
92
Name and Title of other members: Office Term Expires:
Mickey Peabody June 30, 2016
Lupe Aguilera June 30, 2017
Eileene King June 30, 2017
Jenny Kenoyer June 30, 2018
Maggie Mejia June 30, 2018
Martha Martin June 30, 2018
Billie Taylor June 30, 2018
Ken Hanigan June 30, 2018
Adriana Breugem June 30, 2016
Kathleen Faria June 30, 2018
Huey Lee June 30, 2016
Larry Johnson June 30, 2016
Joanne Lyions June 30, 2018
EJ Houston June 30, 2018
Pat Fantazia June 30, 2016
Stacie Morales June 30, 2016
Joyce Buehner June 30, 2016
Indicate which member(s) represent each of the “Other Representation” categories listed below.
Yes No
Low Income Representative X
Disabled Representative X Supportive Services Provider Representative X Health Care Provider Representative X
Family Caregiver Representative X Local Elected Officials X
Individuals with Leadership Experience in Private and Voluntary Sectors X
Explain any "No" answer(s):
APPROVED
93
Briefly describe the local governing board’s process to appoint Advisory Council members:
Each supervisor appoints two members from his or her district. The supervisor may identify a
potential candidate or a candidate may be recommended as a person interested in serving on the
Commission on Aging. That person is interviewed by the supervisor or the representative of the
supervisor and is subsequently chosen to represent the senior citizens, disabled persons, and caregivers
of that district. The AAA staff and Commission on Aging leadership are notified of the appointment and
the person is admitted as a voting member of the Commission.
APPROVED
94
SECTION 18 - LEGAL ASSISTANCE PSA 30
2016-2020 Four-Year Area Planning Cycle
This section must be completed and submitted with the Four-Year Area Plan.
Any changes to this Section must be documented on this form and remitted with Area Plan Updates.13
1. Specific to Legal Services, what is your AAA’s Mission Statement or Purpose Statement? Statement must include Title IIIB requirements: The AAA in Stanislaus County contracts for the Senior Law Project with the Senior Advocacy
Network, a local non-profit legal firm. The sole purpose for this firm is to address the legal needs of senior citizens, especially those that are culturally and financially challenged.
2. Based on your local needs assessment, what percentage of Title IIIB funding is allocated to Legal Services? 22.02%
3. Specific to Legal Services, has there been a change in your local needs in the past four years? If so, please identify the change (include whether the change affected the level of funding and the difference in funding levels in the past four years).
Yes, there has been a change. The staff of the Senior Advocacy Network has seen more cases of
elder financial abuse, and seniors with Alzheimer’s disease or other forms of dementia who have not done financial planning in terms of trusts, wills or powers of attorney. The funding has not changed in the past 4 years but the staff has seen more consumers, and is spending more time with the clients.
4. Specific to Legal Services, does the AAA’s contract/agreement with the Legal Services
Provider(s) (LSPs) specify that the LSPs are expected to use the California Statewide Guidelines in the provision of OAA legal services? Yes.
5. Does the AAA collaborate with the Legal Services Provider(s) to jointly establish specific priorities issues for legal services? If so what are the top four (4) priority legal issues in your PSA? Yes. Elder Abuse, Housing, Consumer Debt and Public Benefits.
6. Specific to Legal Services, does the AAA collaborate with the Legal Services Provider(s) to jointly identify the target population? If so, what is the targeted senior population in your PSA AND what mechanism is used for reaching the target population? Discussion:
13 For Information related to Legal Services, contact Chisorom Okwuosa at 916 419-7500 or [email protected]
APPROVED
95
Yes. The target population is seniors age 60 and over in Stanislaus County. Specifically low income seniors and those who are at a disadvantage due to their rural location or due to cultural and language issues are given priority. This population is targeted by reaching seniors at Senior Information Fairs, speaking to local clubs, churches and civic groups, frequent articles in the newspaper, brochures, other agency referrals and word-of-mouth. Outreach opportunities are available in urban and rural areas of the County, via the connections with the Stanislaus Elder Abuse Prevention Alliance (SEAPA) and the AAA. Bilingual staff and volunteers assist consumers whose primary language is Spanish and we utilize other translation services when necessary.
7. Specific to Legal Services, what is the targeted senior population and mechanism for reaching targeted groups in your PSA? Discussion: See above.
8. How many legal assistance service providers are in your PSA? Complete table below.
Fiscal Year # of Legal Assistance
Services Providers
2016-2017 1
2017-2018
2018-2019
2019-2020
9. Does your PSA have a hotline for legal services? 1-800-222-1753
10. What methods of outreach are Legal Services providers using? Discuss:
Outreach methods include the news media, senior events county wide, National Night Out (SCAM flyers) Senior Information Fairs, networking with other senior organizations and civic groups, talks to local civic, church and colleges, and brochures distributed at events and through other agencies.
11. What geographic regions are covered by each provider? Complete table below.
Fiscal Year Name of Provider Geographic Region covered
2016-2017 a. Senior Advocacy Network
b.
a. Stanislaus County
b.
APPROVED
96
c. c.
2017-2018
a.
b.
c.
a.
b.
c.
2018-2019
a.
b.
c.
a.
b.
c.
2019-2020
a.
b.
c.
a.
b.
c.
12. Discuss how older adults access Legal Services in your PSA: Consumers access service by telephone, by house calls, by coming to the offices of Senior Law Project by themselves, public transportation, taxi, friends, other senior services volunteers, APS workers, social workers. Access is also available through a website with e-mail contact. 13. Identify the major types of legal issues that are handled by the Title IIIB legal provider(s) in your PSA. Discuss (please include new trends of legal problems in your area):
Elder financial abuse by family members is on the rise. Scams targeting elderly persons are on
the rise and new ones are coming out almost daily. Seniors are living longer but are also experiencing
dementia and are at risk of being financially abused by family members, the public and scam artists.
More seniors are still in their home and they tend to isolate themselves and become targets for
unscrupulous people in their neighborhoods who start out trying to help them, then move in to their
homes and slowly take over.
14. In the past four years, has there been a change in the types of legal issues handled by the Title IIIB legal provider(s) in your PSA? Discuss:
The types of cases have not changed, but there has been an increase, especially cases related to scams.
APPROVED
97
15. What are the barriers to accessing legal assistance in your PSA? Include proposed strategies for overcoming such barriers. Discuss: Transportation to the Senior Advocacy Network office is one of the biggest barriers. The staff
attempts to find appropriate transportation for clients and will provide taxi fare if it is late in the day
and the client has to walk too far to catch public transportation.
Languages other than English can become a barrier. Ethnic Bridge, a translation service, is
accessed if a staff member who can translate for the client is not available.
16. What other organizations or groups does your legal service provider coordinate services with? Discuss: The staff coordinates services with APS to report elder abuse and provide legal representation for
restraining orders.
Catholic Charities – The staff are members of SEAPA (Stanislaus Elder Abuse Prevention Alliance) and they attend the SAFE (Seniors Against Financial Exploitation) seminars; the staff also assists the Ombudsman office with challenging cases and provide legal assistance for clients in facilities.
The District Attorney’s staff and the Family Justice Center staff send the Senior Advocacy Network referrals if a senior needs civil legal assistance that they don’t provide, especially for filing civil elder abuse restraining orders.
Family Partnership Center – The staff conducts a weekly Guardianship Clinic providing free legal services to grandparents who are seeking guardianship of their grandchildren.
Project Sentinel – is consulted for challenging landlord-tenant cases, discrimination and mediations.
Family Law Facilitator’s office refers clients to the Senior Advocacy Network office if they are elderly.
Stanislaus County Recorder’s Office – refers senior clients who need help in the preparation of Deeds for their homes.
Memorial and Doctors Medical Centers – refers cases for Powers of Attorney.
APPROVED
98
PSA 30
SECTION 19 - MULTIPURPOSE SENIOR CENTER ACQUISTION OR CONSTRUCTION COMPLIANCE REVIEW 14
CCR Title 22, Article 3, Section 7302(a)(15)
20-year tracking requirement
X No. Title IIIB funds not used for Acquisition or Construction.
Yes. Title IIIB funds used for Acquisition or Construction.
Complete the chart below.
Title III Grantee and/or Senior Center Type Acq/Cons IB Funds
Awarded % of Tota
Cost
Recapture Period MM/DD/YY
Begin Ends
Compliance Verification
(State Use Only)
Name:
Address:
Name:
Address:
Name:
Address:
Name:
Address:
14 Acquisition is defined as obtaining ownership of an existing facility (in fee simple or by lease for 10 years or more) for use as a
Multipurpose Senior Center.
APPROVED
99
PSA 30
SECTION 20. FAMILY CAREGIVER SUPPORT PROGRAM
Notice of Intent for Non-Provision of FCSP Multifaceted Systems of Support Services
Older Americans Act Section 373(a) and (b)
2016–2020 Four-Year Planning Cycle
Based on the AAA’s review of current support needs and services for family caregivers and grandparents (or other older relative of a child in the PSA), indicate what services the AAA intends to provide using Title III E and/or matching FCSP funds for both family caregivers and grandparents/older relative caregivers. Check YES or NO for each of the services* identified below and indicate if the service will be provided directly or contracted. If the AAA will not provide a service, a justification for each service is required in the space below. Family Caregiver Services
Category 2016-2017 2017-2018 2018-2019 2019-2020
Family
Caregiver
Information
Services
X Yes No X Direct Contract
X Yes No X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
Family
Caregiver
Access
Assistance
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
Family
Caregiver
Support
Services
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
Family
Caregiver
Respite Care
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
X Yes No
X Direct Contract
Family
Caregiver
X Yes No
X Yes No
X Yes No
X Yes No
APPROVED
100
Supplemental
Services
X Direct Contract X Direct Contract X Direct Contract X Direct Contract
Grandparent Services
*Refer to PM 11-11 for definitions for the above Title IIIE categories. Justification: For each service category checked “no”, explain how it is being addressed within the PSA. The justification must include the following:
• Provider name and address of agency • Description of the service • Where the service is provided (entire PSA, certain counties, etc.)
Category 2016-2017 2017-2018 2018-2019 2019-2020
Grandparent
Information
Services
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Grandparent
Access Assistance
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Grandparent
Support Services
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Grandparent
Respite Care
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Grandparent
Supplemental
Services
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract
Yes X No
Direct Contract APPROVED
101
• Information that influenced the decision not to provide the service (research, needs assessment, survey of senior population in PSA, etc.)
• How the AAA ensures the service continues to be provided in the PSA without the use of Title IIIE funds
The AAA has elected to not access Family Caregiver Support Program funds for services to
grandparents because a comprehensive program serving the needs of grandparents and their
grandchildren exists within the Stanislaus County Behavioral Health and Recovery Services
Department. The Family Partnership Center is located at 421 E. Morris Avenue, Modesto, CA, 95350,
phone-209-558-8550. They are open 8 a.m.-5 p.m., Monday through Friday, with special events planned
for some evenings and weekends.
Grandparent Information Services:
The Family Partnership Center is listed and described on the Stanislaus County website,
www.stancounty.com, through the Behavioral Health and Recovery Services (BHRS) link. In addition to
that means of Public Information, the staff participates in Community Education events by distributing
flyers at fairs throughout the County. Staff members have accepted opportunities to speak to various
groups about their services. A link from the AAA website, www.agingservices.info, to the BHRS web
site is available as a means to provide more information about services for grandparents.
Grandparent Access Services:
Through the published phone number, 209-558-8550, callers are given information about the
various services available for seniors caring for minor children. Staff members that attend the
community events listed above often spend time giving specific information and assisting attendees to
access their services. Bilingual staff members assist mono-lingual Hispanic clients. Once per month a
lawyer from the Senior Advocacy Network, the Senior Law Project contractor, donates time to complete
necessary paperwork for guardianship applications, as well as other potential legal issues.
Grandparent Support Services:
The Kinship Program within the Family Partnership Center provides culturally comprehensive support
services to senior caregivers who are raising their grandchildren. Their main purpose is to provide access to
seamless services for caregivers, and stability in family life for their grandchildren. These services are available to
any Stanislaus County resident. Support groups are held in Oakdale, Turlock and Modesto. In addition, the
APPROVED
102
“Caregiver Information, Services and Resources Booklet”, available at the www.agingservices.info web site,
includes the name and contact information for support groups facilitated by the Family Partnership Center.
Grandparent Respite Services:
Respite services for grandparents include monthly Movie Nights and daily after school programs, giving a
safe place for the children to go for fun and study time, while giving their grandparents a break or allowing them
to work. The fun and after-school programs are available in Oakdale, Turlock and Modesto. The after school
programs include crafts classes and exercise opportunities.
Grandparent Supplemental Services:
For Supplemental Services, all caregivers who are not caring for a frail elder, but need assistance
with other issues are referred to various agencies that specialize in handling different situations. Some
caregivers have been assisted through the local Central Valley Opportunity Center for rental and/or
energy needs. Others have been referred to Advancing Vibrant Communities, a non-profit agency that
connects volunteers to people with requests for in-home adaptations that can assist the caregiver. The
AAA Information and Assistance staff use their knowledge, resources and persuasive capacity to find
applicable services for caregivers.
The decision to not access Family Caregiver Support Program funds for grandparents raising
their grandchildren was made due to the need to concentrate on using the limited funds for services to
caregivers of frail elders. Stanislaus County BHRS has been engaged in services to grandparents for
many years, with well-established programs throughout the County. When the AAA staff refers
caregivers to the Family Partnership Center we know that they will get the services they need and we
will not be duplicating services.
The AAA Director is part of the Healthy Communities Committee created by the Stanislaus
County Board of Supervisors. This Committee includes the directors of the Health Services Agency,
BHRS, the AAA, and Community Services Agency of Stanislaus County. The Committee was created
to increase coordination of services within the community. At regular meetings there is the opportunity
to share about available and on-going services, as well as the challenges faced by various programs. APPROVED
103
SECTION 21 - ORGANIZATION CHART
APPROVED
104
SECTION 22 - ASSURANCES Pursuant to the Older Americans Act Amendments of 2006 (OAA), the Area Agency on Aging assures that it will: A. Assurances 1. OAA 306(a)(2)
Provide an adequate proportion, as required under OAA 2006 307(a)(2), of the amount allotted for part B to the planning and service area will be expended for the delivery of each of the following categories of services— (A) services associated with access to services (transportation, health services (including mental health services) outreach, information and assistance, (which may include information and assistance to consumers on availability of services under part B and how to receive benefits under and participate in publicly supported programs for which the consumer may be eligible) and case management services); (B) in-home services, including supportive services for families of older individuals who are victims of Alzheimer’s disease and related disorders with neurological and organic brain dysfunction; and (C) legal assistance; and assurances that the area agency on aging will report annually to the State agency in detail the amount of funds expended for each such category during the fiscal year most recently concluded;
2. OAA 306(a)(4)(A)(i)(I-II) (I) provide assurances that the area agency on aging will -
(aa) set specific objectives, consistent with State policy, for providing services to older individuals with greatest economic need, older individuals with greatest social need, and older individuals at risk for institutional placement; (bb) include specific objectives for providing services to low-income minority older individuals, older individuals with limited English proficiency, and older individuals residing in rural areas; and;
(II) include proposed methods to achieve the objectives described in (aa) and (bb) of sub-clause (I);
3. OAA 306(a)(4)(A)(ii)
Include in each agreement made with a provider of any service under this title, a requirement that such provider will— (I) specify how the provider intends to satisfy the service needs of low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in the area served by the provider; (II) to the maximum extent feasible, provide services to low-income minority individuals, older individuals with limited English proficiency, and older individuals residing in rural areas in accordance with their need for such services; and
(III) meet specific objectives established by the area agency on aging, for providing services to low-income minority individuals, older individuals with limited English
APPROVED
105
proficiency, and older individuals residing in rural areas within the planning and service area; 4. OAA 306(a)(4)(A)(iii)
With respect to the fiscal year preceding the fiscal year for which such plan is prepared—
(I) identify the number of low-income minority older individuals in the planning and service area; (II) describe the methods used to satisfy the service needs of such minority older individuals; and (III) provide information on the extent to which the area agency on aging met the objectives described in assurance number 2.
5. OAA 306(a)(4)(B) Use outreach efforts that —
(i) identify individuals eligible for assistance under this Act, with special emphasis on— (I) older individuals residing in rural areas;
(II) older individuals with greatest economic need (with particular attention to low-income minority individuals and older individuals residing in rural areas); (III) older individuals with greatest social need (with particular attention to low-income minority individuals and older individuals residing in rural areas);
(IV) older individuals with severe disabilities; (V) older individuals with limited English proficiency;
(VI) older individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction (and the caretakers of such individuals); and
(VII) older individuals at risk for institutional placement; and (ii) inform the older individuals referred to in sub-clauses (I) through (VII) of clause (i), and the caretakers of such individuals, of the availability of such assistance;
6. OAA 306(a)(4)(C)
Ensure that each activity undertaken by the agency, including planning, advocacy, and systems development, will include a focus on the needs of low-income minority older individuals and older individuals residing in rural areas;
7. OAA 306(a)(5)
Coordinate planning, identification, assessment of needs, and provision of services for older individuals with disabilities, with particular attention to individuals with severe disabilities, and individuals at risk for institutional placement with agencies that develop or provide services for individuals with disabilities;
8. OAA 306(a)(9)
Carry out the State Long-Term Care Ombudsman program under OAA 2006 307(a)(9), will expend not less than the total amount of funds appropriated under this Act and
APPROVED
106
expended by the agency in fiscal year 2000 in carrying out such a program under this title;
9. OAA 306(a)(11)
Provide information and assurances concerning services to older individuals who are Native Americans (referred to in this paragraph as ‘‘older Native Americans’’), including—
(A) information concerning whether there is a significant population of older Native Americans in the planning and service area and if so, the area agency on aging will pursue activities, including outreach, to increase access of those older Native Americans to programs and benefits provided under this title; (B) to the maximum extent practicable, coordinate the services the agency provides under this title with services provided under title VI; and (C) make services under the area plan available, to the same extent as such services are available to older individuals within the planning and service area, to older Native Americans.
10. OAA 306(a)(13)(A-E) (A) maintain the integrity and public purpose of services provided, and service providers, under this title in all contractual and commercial relationships;
(B) disclose to the Assistant Secretary and the State agency— (i) the identity of each nongovernmental entity with which such agency has a contract or commercial relationship relating to providing any service to older individuals; and
(ii) the nature of such contract or such relationship; (C) demonstrate that a loss or diminution in the quantity or quality of the services provided, or to be provided, under this title by such agency has not resulted and will not result from such contract or such relationship; (D) demonstrate that the quantity or quality of the services to be provided under this title by such agency will be enhanced as a result of such contract or such relationship; and (E) on the request of the Assistant Secretary or the State, for the purpose of monitoring compliance with this Act (including conducting an audit), disclose all sources and expenditures of funds such agency receives or expends to provide services to older individuals;
11. 306(a)(14)
Not give preference in receiving services to particular older individuals as a result of a contract or commercial relationship that is not carried out to implement this title;
12. 306(a)(15) Funds received under this title will be used—
(A) to provide benefits and services to older individuals, giving priority to older individuals identified in OAA 2006 306(a)(4)(A)(i); and
APPROVED
107
(B) in compliance with the assurances specified in OAA 2006 306(a)(13) and the limitations specified in OAA 2006 212;
B. Additional Assurances: Requirement: OAA 305(c)(5)
In the case of a State specified in subsection (b)(5), the State agency; and shall provide assurance, determined adequate by the State agency, that the area agency on aging will have the ability to develop an area plan and to carry out, directly or through contractual or other arrangements, a program in accordance with the plan within the planning and service area. Requirement: OAA 307(a)(7)(B) (i) no individual (appointed or otherwise) involved in the designation of the State agency or an area agency on aging, or in the designation of the head of any subdivision of the State agency or of an area agency on aging, is subject to a conflict of interest prohibited under this Act; (ii) no officer, employee, or other representative of the State agency or an area agency on aging is subject to a conflict of interest prohibited under this Act; and (iii) mechanisms are in place to identify and remove conflicts of interest prohibited under this Act. Requirement: OAA 307(a)(11)(A) (i) enter into contracts with providers of legal assistance, which can demonstrate the experience or capacity to deliver legal assistance; (ii) include in any such contract provisions to assure that any recipient of funds under division (i) will be subject to specific restrictions and regulations promulgated under the Legal Services Corporation Act (other than restrictions and regulations governing eligibility for legal assistance under such Act and governing membership of local governing boards) as determined appropriate by the Assistant Secretary; and (iii) attempt to involve the private bar in legal assistance activities authorized under this title, including groups within the private bar furnishing services to older individuals on a pro bono and reduced fee basis. Requirement: OAA 307(a)(11)(B) That no legal assistance will be furnished unless the grantee administers a program designed to provide legal assistance to older individuals with social or economic need and has agreed, if the grantee is not a Legal Services Corporation project grantee, to coordinate its services with existing Legal Services Corporation projects in the planning and service area in order to concentrate the use of funds provided under this title on individuals with the greatest such need; and the area agency on aging makes a finding, after assessment, pursuant to standards for service promulgated by the Assistant Secretary, that any grantee selected is the entity best able to provide the particular services.
APPROVED
108
Requirement: OAA 307(a)(11)(D) To the extent practicable, that legal assistance furnished under the plan will be in addition to any legal assistance for older individuals being furnished with funds from sources other than this Act and that reasonable efforts will be made to maintain existing levels of legal assistance for older individuals; and Requirement: OAA 307(a)(11)(E) Give priority to legal assistance related to income, health care, long-term care, nutrition, housing, utilities, protective services, defense of guardianship, abuse, neglect, and age discrimination. Requirement: OAA 307(a)(12)(A) In carrying out such services conduct a program consistent with relevant State law and coordinated with existing State adult protective service activities for - (i) public education to identify and prevent abuse of older individuals; (ii) receipt of reports of abuse of older individuals; (iii) active participation of older individuals participating in programs under this Act through outreach, conferences, and referral of such individuals to other social service agencies or sources of assistance where appropriate and consented to by the parties to be referred; and (iv) referral of complaints to law enforcement or public protective service agencies where appropriate. Requirement: OAA 307(a)(15) If a substantial number of the older individuals residing in any planning and service area in the State are of limited English-speaking ability, then the State will require the area agency on aging for each such planning and service area - (A) To utilize in the delivery of outreach services under Section 306(a)(2)(A), the services of workers who are fluent in the language spoken by a predominant number of such older individuals who are of limited English-speaking ability. (B) To designate an individual employed by the area agency on aging, or available to such area agency on aging on a full-time basis, whose responsibilities will include: (i) taking such action as may be appropriate to assure that counseling assistance is made available to such older individuals who are of limited English-speaking ability in order to assist such older individuals in participating in programs and receiving assistance under this Act; and (ii) providing guidance to individuals engaged in the delivery of supportive services under the area plan involved to enable such individuals to be aware of cultural sensitivities and to take into account effective linguistic and cultural differences. Requirement: OAA 307(a)(18) Conduct efforts to facilitate the coordination of community-based, long-term care services, pursuant to Section 306(a)(7), for older individuals who - (A) reside at home and are at risk of institutionalization because of limitations on their ability to function independently;
(B) are patients in hospitals and are at risk of prolonged institutionalization; or (C) are patients in long-term care facilities, but who can return to their homes if community-based services are provided to them.
APPROVED
109
Requirement: OAA 307(a)(26) That funds received under this title will not be used to pay any part of a cost (including an administrative cost) incurred by the State agency, or an area agency on aging, to carry out a contract or commercial relationship that is not carried out to implement this title. Requirement: OAA 307(a)(27) Provide, to the extent feasible, for the furnishing of services under this Act, consistent with self-directed care. C. Code of Federal Regulations (CFR), Title 45 Requirements: CFR [1321.53(a)(b)] (a) The Older Americans Act intends that the area agency on aging shall be the leader relative to all aging issues on behalf of all older persons in the planning and service area. This means that the area agency shall proactively carry out, under the leadership and direction of the State agency, a wide range of functions related to advocacy, planning, coordination, interagency linkages, information sharing, brokering, monitoring and evaluation, designed to lead to the development or enhancement of comprehensive and coordinated community based systems in, or serving, each community in the Planning and Service Area. These systems shall be designed to assist older persons in leading independent, meaningful and dignified lives in their own homes and communities as long as possible. (b) A comprehensive and coordinated community-based system described in paragraph (a) of this section shall: (1) Have a visible focal point of contact where anyone can go or call for help, information or referral on any aging issue; (2) Provide a range of options: (3) Assure that these options are readily accessible to all older persons: The independent, semi-dependent and totally dependent, no matter what their income; (4) Include a commitment of public, private, voluntary and personal resources committed to supporting the system; (5) Involve collaborative decision-making among public, private, voluntary, religious and fraternal organizations and older people in the community; (6) Offer special help or targeted resources for the most vulnerable older persons, those in danger of losing their independence; (7) Provide effective referral from agency to agency to assure that information or assistance is received, no matter how or where contact is made in the community; (8) Evidence sufficient flexibility to respond with appropriate individualized assistance, especially for the vulnerable older person; (9) Have a unique character which is tailored to the specific nature of the community; (10) Be directed by leaders in the community who have the respect, capacity and authority necessary to convene all interested individuals, assess needs, design solutions, track overall success, stimulate change and plan community responses for the present and for the future.
APPROVED
110
CFR [1321.53(c)] The resources made available to the area agency on aging under the Older Americans Act are to be used to finance those activities necessary to achieve elements of a community based system set forth in paragraph (b) of this section. CFR [1321.53(c)] Work with elected community officials in the planning and service area to designate one or more focal points on aging in each community, as appropriate. CFR [1321.53(c)] Assure access from designated focal points to services financed under the Older Americans Act. CFR [1321.53(c)] Work with, or work to assure that community leadership works with, other applicable agencies and institutions in the community to achieve maximum collocation at, coordination with or access to other services and opportunities for the elderly from the designated community focal points. CFR [1321.61(b)(4)] Consult with and support the State's long-term care ombudsman program. CFR [1321.61(d)] No requirement in this section shall be deemed to supersede a prohibition contained in the Federal appropriation on the use of Federal funds to lobby the Congress; or the lobbying provision applicable to private nonprofit agencies and organizations contained in OMB Circular A-122. CFR [1321.69(a)] Persons age 60 and older who are frail, homebound by reason of illness or incapacitating disability, or otherwise isolated, shall be given priority in the delivery of services under this part.
APPROVED